California Licensed Compliance Consultant

Job Summary

Serving as a compliance subject matter expert, the full-time remote California Licensed Compliance Consultant will manage complex targeted reviews and external Risk Adjustment-related audits, develop project workplans, and monitor quality assurance for the Risk Adjustment Compliance Coding team.

Key responsibilities

• Conducts business-specific projects and oversees compliance activities by applying subject matter expertise and coordinating resources
• Leads compliance reporting efforts, summarizing data and audit information while developing presentations for management
• Drives regulatory compliance by monitoring changes and implementing necessary compliance efforts across the organization

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 institutions