California Licensed Compliance Manager

Job Summary

To support Health Plan Risk Adjustment operations, the full-time remote California Licensed Compliance Manager will oversee compliance activities, manage coding audits, ensure regulatory adherence, and collaborate with cross-functional teams to enhance coding quality and audit readiness.

Key responsibilities:

• Manage compliance activities and audit processes related to medical coding across all care settings
• Develop and implement the annual coding audit plan in collaboration with compliance teams
• Analyze compliance data and regulatory changes, providing strategic direction to mitigate risks

Required qualifications:

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