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 compliance while working remotely.

Key responsibilities:

• Manage compliance activities by partnering with stakeholders and overseeing strategic compliance initiatives
• Develop and implement the annual coding audit plan, ensuring coding integrity and compliance with national policies
• Evaluate compliance data and audit information, reporting key findings and potential risks to senior management

Required qualifications:

• Minimum six (6) years of medical coding experience
• Minimum three (3) years of leadership experience in a related field
• Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or a related field, along with eight (8) years of relevant experience
• Certification as a Coding Specialist or Risk Adjustment Coder from recognized professional organizations
• Experience in health care compliance, operations, audit, or regulatory development