California Licensed Compliance Manager
Job Summary
To support Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Manager will oversee compliance oversight, audit readiness, and coding validation while working remotely to ensure accurate risk capture and regulatory compliance.
Key responsibilities:
- Manage compliance activities by partnering with stakeholders and overseeing strategic compliance initiatives
- Develop and present coding education and training, while evaluating the quality of coding assignments across all lines of business
- Lead compliance investigations and manage reporting efforts, identifying key compliance drivers and potential risks
Required qualifications:
- Minimum five (5) years of medical coding experience
- Minimum two (2) years of experience in a leadership role
- Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or related field with six (6) years of relevant experience
- Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder
- Experience in health care compliance, operations, audit, or regulatory policy development
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