California Licensed Compliance Consultant
Job Summary
To support Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Consultant will manage compliance oversight, conduct coding validation, and perform data-driven analysis while working remotely.
Key responsibilities
- Conducts compliance activities by partnering with stakeholders and applying regulations to ensure adherence to standards
- Leads compliance reporting efforts, summarizing data and presenting key findings to management
- Drives regulatory compliance by monitoring changes and implementing necessary adjustments to policies and procedures
Required qualifications
- Minimum six (6) years of medical coding experience
- Minimum three (3) years 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 or equivalent certification from recognized organizations
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