California Licensed Compliance Consultant

Supporting Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Consultant will manage compliance oversight, conduct coding validation, and perform data-driven analysis to ensure regulatory compliance and coding integrity, working remotely within authorized states. Key responsibilities Conducts compliance activities by partnering with stakeholders and applying regulations to design and execute strategic compliance initiatives Leads compliance reporting efforts by evaluating compliance data and developing presentations to convey findings to management Drives regulatory compliance by monitoring regulatory changes and overseeing the implementation of necessary adjustments 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 with a minimum of eight (8) years of relevant experience Certified Coding Specialist from the American Health Information Management Association OR Certified Risk Adjustment Coder OR Certified Professional Coder from the American Academy of Professional Coders Experience in health care compliance, operations, audit, finance, or regulatory development