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 while working remotely from an authorized state.

Key responsibilities:

• Manage compliance activities and oversee the design and execution of strategic compliance initiatives
• Develop and present coding education seminars while evaluating coding quality across all lines of business
• Collaborate with operational, clinical, and compliance teams to identify risks and improve coding quality

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, operations, audit, or a directly related field