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 adherence to regulatory standards while working remotely.
Key responsibilities
- Manage compliance reporting efforts by evaluating compliance data, audit information, and potential risks
- Direct coding validation and documentation reviews to ensure accurate risk capture and coding integrity
- Develop and present coding educational inservices and seminars while collaborating with operational and clinical teams
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 a 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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