California Licensed Compliance Consultant
Job Summary
To support Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Consultant will manage compliance oversight, coding validation, and audit readiness while working remotely to ensure regulatory compliance and coding integrity.
Key responsibilities:
- Conduct compliance activities by partnering with stakeholders and applying established regulations to design and execute compliance initiatives
- Lead compliance reporting efforts by evaluating compliance data and developing presentations to convey key findings to management
- Drive regulatory compliance by monitoring changes and overseeing the implementation of designated compliance efforts
Required qualifications:
- Minimum six (6) years medical coding experience
- Minimum three (3) years experience in a leadership role
- Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or related field, along with eight (8) years of relevant experience
- Certified Coding Specialist, Certified Risk Adjustment Coder, or Certified Professional Coder certification
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