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
• Direct coding validation and documentation review to ensure accurate risk capture and coding integrity
• Develop and present coding educational inservices while evaluating coding quality 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 related field
• Minimum six (6) years of experience in health care compliance, operations, audit, or related fields
• Certification as a Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder