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.

Key responsibilities:

• Manage compliance activities by partnering with stakeholders and overseeing strategic compliance initiatives
• Perform coding validation and documentation review to ensure accurate risk capture and coding integrity
• Develop and present coding education and training programs 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 a related field, along with six (6) years of relevant experience
• Certification as a Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder
• Experience in health care compliance, operations, audit, or regulatory development