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.

Key responsibilities:

• Manage compliance reporting efforts by evaluating compliance data and presenting key findings to leadership
• Oversee coding validation and documentation review to ensure accurate risk capture and coding integrity
• Develop and execute 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 coding certification
• Minimum eight (8) years of experience in health care compliance or related fields