California Licensed Compliance Manager
Job Summary
To support Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Manager will oversee compliance activities, manage coding audits, and ensure regulatory adherence, working remotely within authorized states.
Key responsibilities
- Manage compliance activities by partnering with stakeholders and overseeing strategic compliance initiatives
- Develop and execute the annual coding audit plan, ensuring compliance with national coding policies
- Lead coding validation and documentation reviews to enhance coding quality and support audit activities
Required qualifications
- Minimum five (5) years of medical coding experience
- Minimum two (2) years in a leadership role
- Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or related field
- Certified Risk Adjustment Coder or equivalent coding certification
- Minimum six (6) years of experience in health care compliance or related fields
Complete Job Description
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