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.
Key responsibilities:
- Manage compliance activities by partnering with stakeholders and overseeing strategic compliance initiatives
- Conduct coding validation and documentation reviews to ensure regulatory compliance and coding integrity
- Develop and implement the annual coding audit plan in collaboration with reimbursement compliance teams
Required qualifications:
- Minimum six (6) years of medical coding experience
- Minimum three (3) years of experience in a leadership role
- Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or related field
- Certified Coding Specialist or equivalent certification from recognized professional organizations
- Minimum eight (8) years of experience in health care compliance or related fields
Complete Job Description
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