California Licensed Compliance Consultant

Job Summary

To support the Risk Adjustment Coding Compliance team, the full-time California Licensed Compliance Consultant will manage complex targeted reviews and external audits, develop project workplans, and ensure compliance with national coding policies while working remotely.

Key responsibilities

• Oversee business-specific projects by applying expertise, developing work plans, and coordinating resources to meet organizational goals
• Conduct compliance activities by partnering with stakeholders, analyzing regulations, and executing strategic compliance initiatives
• Lead compliance reporting efforts by summarizing data, identifying risks, and presenting key 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 a related field, along with eight (8) years of relevant experience
• Certified Coding Specialist or equivalent certification from recognized professional organizations