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 evaluate compliance data, audit information, and potential risks
- Develop and execute strategic compliance initiatives, ensuring alignment with regulations and standards
- Lead coding validation and documentation reviews to maintain coding integrity and support audit activities
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 a related field, along with eight (8) years of relevant experience
- Certified Coding Specialist or equivalent certification from recognized professional organizations
Complete Job Description
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