California Licensed Compliance Consultant

Job Summary

Serving as a subject matter expert in compliance, the full-time remote California Licensed Compliance Consultant will manage complex risk adjustment coding compliance projects, oversee audits, and ensure adherence to national coding policies while collaborating with cross-functional teams.

Key responsibilities:

• Develop and implement project workplans for targeted reviews and audits, ensuring stakeholder expectations are met
• Monitor and evaluate quality assurance processes for the Risk Adjustment Compliance Coding team, summarizing data from audits
• Lead compliance reporting efforts by analyzing data and presenting findings to management and stakeholders

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
• Certified Coding Specialist or equivalent coding certification
• Minimum eight (8) years of experience in health care compliance, operations, audit, or related fields