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 and analyze compliance data, audit information, and potential risks
- Develop and execute strategic compliance initiatives in partnership with internal and external stakeholders
- Lead coding validation, documentation reviews, and ensure accurate risk capture and coding integrity
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, operations, audit, or a related field
Complete Job Description
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