California Licensed Compliance Manager

Job Summary

To support Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Manager will oversee compliance oversight, coding validation, and audit readiness while working remotely across authorized states.

Key responsibilities:

• Manage compliance activities by partnering with stakeholders and overseeing strategic compliance initiatives
• Direct audit activities related to coding and ensure adherence to national coding policies and procedures
• Develop and present coding education and training programs to enhance team capabilities and compliance understanding

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
• Minimum six (6) years of experience in health care compliance, operations, audit, or a related field
• Certification as a Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder