- Conduct escalated and complex agent and agency investigations related to sales and marketing
- Recommend corrective actions and support remediation activities
- Communicate with internal and external partners, keeping stakeholders informed of case status, emerging risks, and resolution barriers
- Draft and update complex compliance policies, procedures, investigative job aids, and recommend changes based on case and audit trends
- Present case findings to an Agent Review Board for objective decision-making
- Serve as a subject matter resource to Compliance Analysts on investigative methodology, evidence standards, documentation quality, and corrective action precedent
- Identify trends and recommend process, training, and system improvements to reduce investigation cycle time and pending case volume
- Partner with Sales, Sales Operations, Legal, and Technology on issue resolution and investigative workflow system enhancements
- Train Devoted associates joining the compliance team during high-volume season
- Conduct quality assurance reviews to ensure compliance standards are met
- Report to the Sales & Marketing Compliance Manager
Requirements
- Bachelor’s degree
- 2+ years experience in a Medicare Advantage marketing, sales, or compliance role, including hands‑on experience conducting investigations
- Attention to detail, organized and thorough with a desire for continuous process improvements
- Self‑motivated with the ability to adapt to change quickly and strong ability to problem solve
- Takes initiative to organize work effectively and manage a high volume, mixed complexity caseload against defined turnaround times
- Ability to critically assess information from multiple sources, reach a defensible conclusion, and recognize when a matter needs to be escalated
- Demonstrated record of reliably delivering work and projects that meet defined objectives with limited day to day oversight
- Desire and flexibility to collaborate with co‑workers in a virtual environment as a team player
- Experience in conducting monitoring and auditing activities of TPMO’s
Core Competencies
Demonstrates expertise in conducting complex investigations within Medicare Advantage marketing and compliance, with a strong focus on policy development, stakeholder communication, and process improvement. Proven ability to analyze information critically and deliver results in a high‑volume, fast‑paced environment.
Highest‑signal resume keywords
- Medicare Advantage Compliance
- Investigative Methodology
- Policy Development
- Stakeholder Communication
- Process Improvement
Hard Skills
- Investigations
- Compliance Auditing
- Data Analysis
- Quality Assurance
- Corrective Action Recommendations
Soft Skills
- Attention to Detail
- Organizational Skills
- Problem Solving
- Self‑Motivation
- Team Collaboration
Industry Keywords
- Sales Compliance
- Marketing Compliance
- TPMO Monitoring
- Case Management
- Remediation Activities