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 within authorized states.
Key responsibilities:
- Manage compliance reporting and investigations, evaluating data and developing corrective action plans
- Oversee coding validation and documentation reviews to maintain coding integrity and compliance
- Partner with operational and clinical teams to identify risks and drive continuous improvement in coding quality
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
- Certified Risk Adjustment Coder or equivalent coding certification
- Minimum six (6) years of experience in health care compliance or related fields
Complete Job Description
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