California Licensed Compliance Manager
Job Summary
To support Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Manager will manage compliance oversight, audit readiness, and coding validation while working remotely and collaborating with various teams to enhance coding quality and ensure regulatory compliance.
Key responsibilities
- Manage compliance activities by partnering with stakeholders and overseeing strategic compliance initiatives
- Conduct coding validation and documentation reviews to ensure accurate risk capture and coding integrity
- Develop and present educational in-services on coding while evaluating the quality of coding assignments across all lines of business
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, Certified Coding Specialist, or Certified Professional Coder
- Minimum six (6) years of experience in health care compliance, operations, audit, finance, or related fields
Complete Job Description
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