California Licensed Compliance Consultant

Job Summary

Serving as a key consultant on 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 quality assurance for coding compliance, all while working remotely.

Key responsibilities

• Oversee business-specific projects, ensuring adherence to procedures and policies while coordinating resources to meet organizational goals
• Conduct compliance activities by partnering with stakeholders and designing strategic initiatives based on regulatory analysis
• Lead compliance reporting efforts, summarizing data 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 related field, along with eight (8) years of relevant experience
• Certified Coding Specialist or equivalent certification from recognized organizations