California Licensed Compliance Consultant

Job Summary

Supporting Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Consultant will manage compliance oversight, conduct coding validation, and perform data-driven analysis to ensure regulatory compliance and coding integrity in a remote work environment.

Key responsibilities:

• Conduct compliance activities by partnering with stakeholders and executing strategic compliance initiatives
• Lead compliance reporting efforts by evaluating compliance data and developing presentations for management
• Manage projects related to compliance, identifying requirements, assessing current compliance states, and creating corrective action plans

Required qualifications:

• Minimum six (6) years of medical coding experience
• Minimum three (3) years of 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 experience in health care compliance or a directly related field
• Certified Coding Specialist or equivalent certification from recognized organizations