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.

Key responsibilities:

• Manage compliance activities by partnering with stakeholders and overseeing the design and execution of strategic compliance initiatives
• Conduct coding validation and documentation reviews to ensure accurate risk capture and regulatory compliance
• Develop and present educational inservices and seminars 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 in a leadership role
• Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or related field, along with six (6) years of relevant experience
• Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder