California Licensed Compliance Manager

Job Summary

Managing compliance activities for Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Manager will oversee audit readiness, coding validation, and quality assurance reviews while working remotely.

Key responsibilities:

• Directs compliance efforts by partnering with stakeholders and managing the design and execution of strategic compliance initiatives
• Oversees coding audits and ensures adherence to national coding policies, while developing and presenting educational seminars
• Evaluates compliance data and reports key findings to senior management, recommending corrective actions as necessary

Required qualifications:

• Minimum five (5) years of medical coding experience
• Minimum two (2) years in a leadership role, with or without direct reports
• Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or a related field, along with six (6) years of relevant experience
• Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder