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 compliance with national coding policies while working remotely.

Key responsibilities:

• Oversee compliance activities by partnering with stakeholders and applying regulations to compliance efforts
• Lead compliance reporting by evaluating compliance data and developing presentations for management
• Manage projects by coordinating resources, developing project plans, and ensuring adherence to compliance standards

Required qualifications:

• Minimum six (6) years of medical coding experience
• Minimum three (3) years 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
• Experience in health care compliance, operations, or auditing