Sr Mgr, Compliance, Medical Coding

Open to candidates residing in any KP authorized state to include CA, OR, WA, CO, GA, VA, HI, MD & D.C. Please Note: Salary ranges are geographically based. Lower salary ranges will apply for other labor markets outside of NCAL. Support Health Plan Risk Adjustment operations through government audit readiness, compliance oversight, and internal quality assurance reviews. Perform coding validation, documentation review, and data-driven analysis to ensure accurate risk capture, regulatory compliance, and coding integrity. Partner with operational, clinical, and compliance teams to identify risks, improve coding quality, support audit activities, and drive continuous improvement across Risk Adjustment programs.

In addition to the responsibilities listed below, the position is also responsible for serving as a compliance subject matter expert related to coding functions, managing and directing audit activity related to coding within all settings of care, ensuring compliance with national coding policies and procedures, assisting with escalated coding questions and related topics, ensuring teams are educated in latest coding developments, and evaluating the quality of coding assignments across all lines of business. Additionally, this position is responsible for developing the annual coding audit plan in collaboration with reimbursement compliance teams, reviewing reports of audit results, helping set the direction for coding and focused projects related to audit outcomes, and supporting compliance and the Principles of Responsibility (KPs code of conduct).

Pursues professional growth and provides developmental opportunities for others by soliciting and acting on performance feedback; building collaborative, cross-functional relationships; hiring, training, and developing talent for growth opportunities; delegating tasks and decisions; fostering open dialogue amongst departments; strategically evaluating talent for succession planning; setting performance management guidelines and expectations across units; and working closely with employees to set goals and provide open feedback and coaching to drive performance improvement. Manages designated units by translating business plans into tactical action items; communicating goals and objectives; ensuring all policies and procedures are followed; overseeing the completion of work assignments; assuming responsibility for decision making; aligning team efforts; building accountability for and measuring progress in achieving results; incorporating resources, costs, and forecasts into unit plans; removing obstacles that impact performance; guiding performance and developing contingency plans accordingly; partnering with key stakeholders and business leaders to ensure products and/or services meet requirements and expectations while aligning with departmental strategies; and influencing units to operate in alignment with business objectives. Manages company compliance activities by partnering with internal and external stakeholders; applying established regulations and standards to compliance efforts; managing the design, development, and execution of strategic compliance initiatives; overseeing the analysis of regulations and regulatory changes, and their application to operations; and overseeing the documentation of compliance activities. Manages compliance reporting efforts across one or more business functions by managing the evaluation and summary of compliance data, audit information, and potential risks and remedies; identifying and reporting key compliance drivers, liabilities, and performance indicators (for example, adherence to standards, incorporation of new regulations) to senior management; and developing complex presentations to convey key findings to leadership and external business stakeholders. Manages compliance investigations across one or more business functions by managing the collection and analysis of quantitative and