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 to identify key drivers and performance indicators
• Oversee coding validation and documentation reviews to ensure accurate risk capture and coding integrity
• Develop and implement strategic compliance initiatives in collaboration with operational and clinical teams

Required qualifications:

• Minimum six (6) years of medical coding experience
• Minimum three (3) years of leadership experience in a relevant field
• Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or a related field with eight (8) years of experience in health care compliance or related areas
• Certified Coding Specialist or equivalent certification from recognized organizations
• Experience in health care operations, audit, finance, or regulatory compliance