CenCal Health, the community-accountable Medi-Cal health plan for Santa Barbara and San Luis Obispo counties, has named Carl R. Breining to the position of compliance and privacy officer.
Breining, a certified healthcare constructor (CHC), brings 14 years of experience in health care policy compliance, and some 20 years of managerial experience with a Fortune 10 company. His skill and knowledge base will support CenCal Health’s partnership with some 1,500 local physicians, hospitals and other providers to deliver patient care to nearly 200,000 Medi-Cal members on the Central Coast.
Breining began his new position at CenCal Health in November. Under the direction of CenCal Health’s general counsel, Breining now serves as the health plan’s primary executor and administrator of its compliance program, overseeing company-wide policies and procedures as they relate to federal, state and local regulations.
The position is responsible for compliance with all regulatory and contract requirements, and for conducting, coordinating, and reporting audit and investigative activities for the purpose of preventing and detecting fraud, waste and abuse.
“Carl’s breadth of experience and knowledge regarding Medi-Cal managed care plans will certainly be an asset for CenCal Health’s future,” said Karen S. Kim, CenCal Health general counsel. “I am excited to see that experience manifested through his guidance and leadership of new and existing compliance initiatives.”
Breining comes to CenCal Health from prior positions in risk-management, compliance and regulatory affairs at Health Plan of San Joaquin and Kern Health Systems, both Medi-Cal managed care plans operating in California’s Central Valley.
“It’s an honor for me to lead the compliance team for CenCal Health, whose mission has been to serve the needs of the community for more than three decades,” said Breining. “I look forward to this fabulous career opportunity as this venerable health plan continues to grow.”
For more on CenCal Health, visit cencalhealth.org. CenCal Health’s new annual Community Report can be viewed at cencal2020.org.