California Licensed Compliance Manager

Job Summary

Supporting Health Plan Risk Adjustment operations, the full-time remote California Licensed Compliance Manager will manage compliance activities, oversee coding validation and documentation review, and collaborate with cross-functional teams to ensure regulatory compliance and improve coding quality.

Key responsibilities:

• Manage compliance reporting and investigations, analyzing data and developing corrective action plans
• Develop and execute strategic compliance initiatives, ensuring adherence to regulations and standards
• Oversee the annual coding audit plan and drive continuous improvement across Risk Adjustment programs

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