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Blue Shield of CaliforniaPosted 1 month ago

Risk Adjustment Compliance Specialist, Principal

On-siteOakland, California, United States

Full TimeSenior LevelLargeHealthcare Tech

Job Summary

Audit, monitor, and evaluate risk adjustment processes across the Marketplace (ACA), Medicaid, and Medicare Advantage lines of business. Identify areas of non-compliance and recommend corrective actions to ensure organizational adherence to relevant laws. Collaborate with internal teams and external partners to maintain data integrity and support the development and implementation of compliance programs. This role requires a Principal-level candidate with deep expertise in ACA regulations.

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