California Licensed Compliance Consultant

Job Summary

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

Key responsibilities:

• Oversee compliance reporting efforts by evaluating compliance data and developing presentations for management
• Conduct business-specific projects by applying expertise and coordinating resources to meet organizational goals
• Lead compliance investigations by analyzing data, conducting interviews, and recommending corrective action plans

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, Certified Risk Adjustment Coder, or Certified Professional Coder certification
• Minimum eight (8) years of experience in health care compliance or related fields