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 audit readiness, and ensure coding integrity while working remotely.
Key responsibilities:
- Manage compliance activities by partnering with stakeholders and overseeing compliance initiatives
- Develop and execute the annual coding audit plan, ensuring adherence to regulations and standards
- Conduct coding validation and documentation reviews to improve coding quality and support audit activities
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 a related field
- Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder
- Minimum six (6) years of experience in health care compliance, operations, audit, or a related field
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