California Licensed Compliance Consultant
Job Summary
To support Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Consultant will manage government audit readiness, compliance oversight, and internal quality assurance reviews while working remotely.
Key responsibilities
- Conduct compliance activities and audits, ensuring adherence to regulations and standards
- Lead compliance reporting efforts by evaluating compliance data and summarizing key findings for management
- Drive regulatory compliance by monitoring changes and implementing necessary adjustments to compliance standards and policies
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 a related field, along with a minimum of eight (8) years in health care compliance or related fields
- Certified Coding Specialist or equivalent certification from recognized organizations
Complete Job Description
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