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 regulatory compliance, while working remotely from authorized states.
Key responsibilities:
- Oversee coding compliance activities and manage audit processes across various care settings
- Partner with operational and clinical teams to enhance coding quality and support continuous improvement initiatives
- Develop and present educational inservices on coding compliance and evaluate coding assignments for quality assurance
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, along with six (6) years of relevant experience
- Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder certification
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