Utilization Management Director, Compliance

Utilization Management Director, Compliance at Kaiser Permanente

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campaign-Day company_name-Compliance-General hours_per_week-40 industry-NUE-GA-01|NUE|Non-Union-Employee job_level-Director/Senior-Director job_status-Regular job_type-Standard salary_relocation-Full-time travel-Yes,-15-%-of-the-Time custom_fields.EEO-Kaiser-Permanente-is-an-equal-opportunity-employer-committed-to-fair,-respectful,-and-inclusive-workplaces.-Applicants-will-be-considered-for-employment-without-regard-to-race,-religion,-sex,-age,-national-origin,-disability,-veteran-status,-or-any-other-protected-characteristic-or-status. custom_fields.ReqID-1416741 custom_fields.Shift-Day custom_fields.Field1-Compliance-/-Privacy-/-Regulatory custom_fields.Field2-Mon,-Tue,-Wed,-Thu,-Fri custom_fields.Reindex-2 custom_fields.MHSTheme-No custom_fields.PayBasis-Yearly custom_fields.PayRange-$163500---$211530-/-year custom_fields.core_ksa-

Knowledge,-Skills-and-Abilities:-(Core)

• Ambiguity/Uncertainty-Management
• Attention-to-Detail
• Business-Knowledge
• Communication
• Constructive-Feedback
• Critical-Thinking
• Cross-Group-Collaboration
• Decision-Making
• Dependability
• Diversity,-Equity,-and-Inclusion-Support
• Drives-Results
• Facilitation-Skills
• Health-Care-Industry
• Influencing-Others
• Integrity
• Leadership
• Learning-Agility
• Organizational-Savvy
• Problem-Solving
• Short--and-Long-term-Learning-&-Recall
• Strategic-Thinking
• Team-Building
• Teamwork
• Topic-Specific-Communication

custom_fields.Specialty-Compliance-General custom_fields.Department-Regional-Office---9-Piedmont---Assoc-Rgnl-Med-Facility---2808 custom_fields.core_ksa_2-

Knowledge,-Skills-and-Abilities:-(Core)

• Ambiguity/Uncertainty-Management
• Attention-to-Detail
• Business-Knowledge
• Communication
• Constructive-Feedback
• Critical-Thinking
• Cross-Group-Collaboration
• Decision-Making
• Dependability
• Diversity,-Equity,-and-Inclusion-Support
• Drives-Results
• Facilitation-Skills
• Health-Care-Industry
• Influencing-Others
• Integrity
• Leadership
• Learning-Agility
• Organizational-Savvy
• Problem-Solving
• Short--and-Long-term-Learning-&-Recall
• Strategic-Thinking
• Team-Building
• Teamwork
• Topic-Specific-Communication

custom_fields.jobtitleLI-Utilization-Management-Director,-Compliance---1416741 custom_fields.leadership-no custom_fields.CFSalaryLow-163500 custom_fields.HawaiiTheme-Compliance-/-Privacy-/-Regulatory custom_fields.JobSchedule-Full-time custom_fields.PostAddress-Georgia,Atlanta,Regional-Office---9-Piedmont custom_fields.ShiftFilter-Day custom_fields.customtheme-Compliance-/-Privacy-/-Regulatory custom_fields.CFSalaryHigh-211530 custom_fields.LocationName-Georgia custom_fields.SchemaHiring-Kaiser-Permanente custom_fields.LocationValue-Georgia custom_fields.employeegroup-NUE-GA-01|NUE|Non-Union-Employee custom_fields.WorkerLocation-Onsite custom_fields.employeestatus-Regular custom_fields.functional_ksa-

Knowledge,-Skills-and-Abilities:-(Functional)

• Analytical-Skills
• Compliance-Management
• Cross-Department-Coordination
• Getting-Work-Done-Through-Others
• Negotiation
• Project-Management
• Technical-Communication
• Written-Communication

custom_fields.WorkingHoursEnd-05:00-PM custom_fields.JobScheduleField-Full-time custom_fields.functional_ksa_2-

Knowledge,-Skills-and-Abilities:-(Functional)

• Analytical-Skills
• Compliance-Management
• Cross-Department-Coordination
• Getting-Work-Done-Through-Others
• Negotiation
• Project-Management
• Technical-Communication
• Written-Communication

custom_fields.WorkingHoursStart-09:00-AM custom_fields.PrefQualification1-

• Minimum-Qualifications:
• Minimum-four-(4)-years-experience-in-a-leadership-role-with-or-without-direct-reports.
• Bachelors-degree-in-Health-Care-Administration,-Clinical,-Law,-Public-Health,-Business-or-related-field-and-Minimum-ten-(10)-years-experience-in-compliance,-health-care-operations-(quality,-risk,-etc.),-audit,-finance,-regulatory-or-public-policy-development,-investigations,-information-security,-or-insurance/health-plan-governance-or-a-directly-related-field.-Additional-equivalent-work-experience-in-a-directly-related-field-may-be-substituted-for-the-degree-requirement.

Preferred-Qualifications:

• Five-(5)-years-experience-working-in-a-clinical-setting-(e.g.,-hospital,-medical-center).
• Five-(5)-years-experience-in-health-plan-compliance.

custom_fields.LocationDescription-Georgia,Atlanta,Regional-Office---9-Piedmont custom_fields.NurseResidencyTheme-Compliance-/-Privacy-/-Regulatory custom_fields.VisionServicesTheme-Compliance-/-Privacy-/-Regulatory custom_fields.ExternalReferenceCode-1416741 custom_fields.InternalReferralTheme-Compliance-/-Privacy-/-Regulatory custom_fields.PhysicianAssistantTheme-Compliance-/-Privacy-/-Regulatory custom_fields.CFIsSignOnBonusAvailable-No custom_fields.FacilityServicesandMaterialsManagementTheme-Compliance-/-Privacy-/-Regulatory

Compliance, Privacy & Regulatory

Integrity starts with you

With a focus on promoting honesty and reliability in all our daily actions, you'll ensure that we uphold the highest standards throughout our system.

custom_fields.customtheme-Compliance-/-Privacy-/-Regulatory

Utilization Management Director, Compliance

Primary Location Atlanta, Georgia Schedule Full-time Shift Day Salary $163500 - $211530 / year

Job Number 1416741 Date Posted 04/13/2026

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Job Summary:

Health plan utilization management compliance experience. This director level position is primarily responsible for overseeing company compliance activities including designing strategies for the implementation of regulatory changes. Responsibilities include directing compliance reporting efforts, compliance investigation, and activities associated with continued regulatory compliance across multiple business functions. Additional key responsibilities include directing and overseeing the implementation of compliance efforts through approving requirements and monitoring ongoing compliance adherence. This managing level employee also directs programs or compliance components of larger cross-functional programs including identifying and managing stakeholders.

Essential Responsibilities:

• Demonstrates continuous learning and maintains a highly skilled and engaged workforce by aligning resource plans with business objectives; overseeing the recruitment, selection, and development of talent; motivating teams; preparing individuals for growth opportunities and advancement; staying current with industry trends, benchmarks, and best practices; providing guidance when difficult decisions need to be made; and ensuring performance management guidelines and expectations drive business needs.
• Oversees the operation of multiple units and/or departments by identifying customer and operational needs; analyzing resources, costs, and forecasts and incorporating them into business plans; gaining cross-functional support for business plans and priorities; translating business strategy into actionable business requirements; obtaining and distributing resources; setting standards and measuring progress; removing obstacles that impact performance; guiding performance and developing contingency plans accordingly; and ensuring products and/or services meet customer requirements and expectations while aligning with organizational strategies.
• Oversees company compliance activities by ensuring team members, including external business partners, provide support to internal and external stakeholders; reviewing and approving compliance activities; designing strategies for the implementation of regulations and regulatory changes; ensuring compliance activities are fully documented; and overseeing the resolution of compliance issues.
• Directs compliance reporting efforts across multiple business functions by overseeing the evaluation and summary of compliance data, audit information, and potential risks and remedies; identifying and reporting key compliance drivers, liabilities, and performance indicators (for example, adherence to standards, incorporation of new regulations) to senior management; and developing complex presentations to convey key findings to executive leadership and external business stakeholders.
• Directs compliance investigations across multiple business functions by overseeing the collection and analysis of quantitative and qualitative data; conducting interviews on escalated issues as appropriate; reviewing and evaluating research on key business issues; and evaluating and recommending corrective action plans for substantiated allegations.
• Directs programs or compliance components of larger cross-functional programs by identifying and managing stakeholder contacts; assembling teams based on program needs and team member strengths; developing, analyzing, and managing program plans; negotiating and managing program schedules and resource forecasts; and managing program financials and deliverables.
• Directs activities associated with continued regulatory compliance for multiple business functions by monitoring, interpreting, and designing strategy around regulatory changes; determining the impact of changes to the business; providing direction on implementation of changes throughout the business; and providing regulatory input before and during inspections to minimize the risks of future non-compliance.
• Directs and oversees the implementation of compliance efforts by approving compliance requirements; ensuring the assessment of current state compliance to identify gaps and corrective actions; overseeing the analysis and development of complex compliance standards, policies and procedures, and training; and ensuring the monitoring of ongoing compliance adherence.

Knowledge, Skills and Abilities: (Core)

• Ambiguity/Uncertainty Management
• Attention to Detail
• Business Knowledge
• Communication
• Constructive Feedback
• Critical Thinking
• Cross-Group Collaboration
• Decision Making
• Dependability
• Diversity, Equity, and Inclusion Support
• Drives Results
• Facilitation Skills
• Health Care Industry
• Influencing Others
• Integrity
• Leadership
• Learning Agility
• Organizational Savvy
• Problem Solving
• Short- and Long-term Learning & Recall
• Strategic Thinking
• Team Building
• Teamwork
• Topic-Specific Communication

Knowledge, Skills and Abilities: (Functional)

• Analytical Skills
• Compliance Management
• Cross Department Coordination
• Getting Work Done Through Others
• Negotiation
• Project Management
• Technical Communication
• Written Communication

Minimum Qualifications:

• Minimum four (4) years experience in a leadership role with or without direct reports.
• Bachelors degree in Health Care Administration, Clinical, Law, Public Health, Business or related field and Minimum ten (10) years experience in compliance, health care operations (quality, risk, etc.), audit, finance, regulatory or public policy development, investigations, information security, or insurance/health plan governance or a directly related field. Additional equivalent work experience in a directly related field may be substituted for the degree requirement.

Preferred Qualifications:

• Five (5) years experience working in a clinical setting (e.g., hospital, medical center).
• Five (5) years experience in health plan compliance.

Primary Location: Georgia,Atlanta,Regional Office - 9 Piedmont Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 09:00 AM Working Hours End: 05:00 PM Job Schedule: Full-time Job Type: Standard Worker Location: Onsite Employee Status: Regular Employee Group/Union Affiliation: NUE-GA-01|NUE|Non Union Employee Job Level: Director/Senior Director Department: Regional Office - 9 Piedmont - Assoc Rgnl Med Facility - 2808 Pay Range: $163500 - $211530 / year Kaiser Permanente is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills and geographic location along with a review of current employees in similar roles to ensure that pay equity is achieved and maintained across Kaiser Permanente. Travel: Yes, 15 % of the Time On-site: Work location is on-site (KP designated office, medical office building or hospital). Worker location must align with Kaiser Permanente's Authorized States policy. Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.

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