Risk Adjustment Compliance Specialist, Principal
Blue Shield of California•Oakland, CA
•$167,896 - $251,720•Hybrid
About The Position
The Risk Adjustment Compliance Specialist, Principal is responsible for ensuring organizational compliance with laws related to Risk Adjustment across our Marketplace (ACA), Medicaid and Medicare Advantage lines of business. This role involves auditing, monitoring, and evaluating risk adjustment processes, identifying areas of non-compliance, and recommending corrective actions. The Principal collaborates with internal teams and external partners to maintain the integrity of risk adjustment data and supports the development and implementation of compliance programs.
Requirements
- Auditing, monitoring, and evaluating risk adjustment processes.
- Identifying areas of non-compliance.
- Recommending corrective actions.
- Collaborating with internal teams and external partners to maintain the integrity of risk adjustment data.
- Supporting the development and implementation of compliance programs.
Responsibilities
- Ensuring organizational compliance with laws related to Risk Adjustment across our Marketplace (ACA), Medicaid and Medicare Advantage lines of business.
- Auditing, monitoring, and evaluating risk adjustment processes.
- Identifying areas of non-compliance.
- Recommending corrective actions.
- Collaborating with internal teams and external partners to maintain the integrity of risk adjustment data.
- Supporting the development and implementation of compliance programs.
Benefits
- Health insurance
- Dental insurance
- Vision insurance
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What This Job Offers
Job Type
Full-time
Career Level
Principal
Education Level
No Education Listed
