Med Supp (Medigap) Compliance Program Manager

SCAN Group; Long Beach (CA); On-site; USD 92,000 - 134,000; Full time

Benefits offered by this job

Wellness program

Paid time off

401(k) matching

Tuition reimbursement

Employee recognition

Job summary

SCAN is a nonprofit health organization focused on improving care for older adults. The Medigap Compliance Program Manager leads independent oversight of Medigap and state regulatory requirements, partnering with Legal Affairs and Operations to ensure effective implementation and ongoing monitoring.

The role serves as the subject matter expert on Medigap requirements, guides regulatory readiness, supports examinations and market conduct reviews, and translates complex rules into actionable

Qualifications

• Bachelor's degree or equivalent combination of education and experience.
• 5+ years of healthcare compliance, regulatory affairs, audit, risk management, Medicare, Medigap, or related experience.
• Experience interpreting and implementing federal and state regulatory requirements.
• Experience conducting compliance risk assessments and providing regulatory guidance to business stakeholders.
• Experience supporting regulatory examinations, audits, investigations, or corrective action activities.
• Medicare Advantage, Part D, and/or Medigap experience.
• Experience working with state Departments of Insurance and state regulatory requirements.
• Experience supporting regulatory examinations, market conduct reviews, audits, or corrective action plans.
• Experience leading cross-functional initiatives in a highly regulated healthcare environment.

Responsibilities

• Oversight of Medigap and state regulatory affairs compliance domains, partnering with business stakeholders to ensure regulatory requirements are effectively implemented, monitored, and maintained.
• Monitor federal and state regulatory requirements with Legal Affairs and operational partners to assess impact and clarify expectations.
• Serve as the subject matter expert on Medigap requirements, including guaranteed issue rules, enrollment rights, underwriting restrictions, product disclosures, and state-specific market requirements.
• Assess how changes in Medigap regulation may impact Medicare Advantage enrollment, member behavior, and business strategy.
• Coordinate the implementation of Department of Insurance regulatory requirements across business areas, ensuring timely and effective compliance.
• Support regulatory examinations, audits, inquiries, and market conduct reviews, coordinating responses to regulatory requests and findings.
• Lead regulatory interpretation and compliance impact assessments for new and evolving requirements; translate regulatory guidance into clear compliance expectations.
• Recommend new or revised compliance policies, standards, and controls to support regulatory requirements.
• Provide compliance guidance and targeted education to assigned functional areas with training materials and sessions.
• Partner with business units to implement compliance requirements, provide regulatory guidance, support issue resolution, and escalate risks as appropriate.

Skills

Regulatory expertise

Medicare knowledge

Analytical thinking

Problem solving

Communication skills

Advisory skills

Time management

Stakeholder influence

State insurance knowledge

Education

Bachelor's degree

Job description

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do.Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults.Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity.At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.The JobThe Med Supp (Medigap) Compliance Program Manager provides independent oversight of assigned components of the Medicare Advantage and Prescription Drug (MAPD) compliance program, with primary responsibility for compliance oversight of the Medigap product and state Department of Insurance regulatory requirements.The role ensures applicable federal and state requirements are effectively implemented, monitored, and maintained, while identifying, assessing, and escalating compliance risks. This position partners with business and operational teams to provide regulatory guidance, evaluate compliance controls, support regulatory readiness, and oversee implementation of state insurance regulatory requirements.You WillAccountable for oversight of assigned Medigap and state regulatory affairs compliance domains, partnering with business stakeholders to ensure regulatory requirements are effectively implemented, monitored, and maintained.Monitor and assess federal and state regulatory requirements in collaboration with Legal Affairs and operational partners to assess compliance impact, clarify expectations, and support business understanding of regulatory changes and updates.Serve as the subject matter expert on Medigap requirements, including guaranteed issue rules, enrollment rights, underwriting restrictions, product disclosures, and state-specific market requirements.Assess how changes in Medigap regulation may impact Medicare Advantage enrollment, member behavior, and business strategy.Coordinate the implementation of Department of Insurance regulatory requirements across business areas, ensuring timely and effective compliance with state insurance obligations.Support regulatory examinations, audits, inquiries, and market conduct reviews, which includes coordinating responses to regulatory requests and findingsLead regulatory interpretation and compliance impact assessments for new and evolving requirements; translate regulatory guidance into clear compliance expectations and advisory support for business areas.Recommend new or revised compliance policies, standards, and controls to support regulatory requirements and sustainable compliance in an evolving business environment, demonstrating the ability to lead through ambiguity.Provide compliance guidance and targeted education to assigned functional areas by contributing to training materials, presentations, and educational sessions that reinforce regulatory expectations, while maintaining independence from training administration and tracking.Partner with business units and stakeholders to facilitate implementation of compliance requirements, provide regulatory guidance, support issue resolution, and escalate compliance risks as appropriate.We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.Actively support the achievement of SCAN’s Vision and Goals.Other duties as assigned.Your Qualifications• Bachelor's degree or equivalent combination of education and experience.• 5+ years of healthcare compliance, regulatory affairs, audit, risk management, Medicare, Medigap, or related experience.• Experience interpreting and implementing federal and state regulatory requirements.• Experience conducting compliance risk assessments and providing regulatory guidance to business stakeholders.• Experience supporting regulatory examinations, audits, investigations, or corrective action activities.• Medicare Advantage, Part D, and/or Medigap experience.• Experience working with state Departments of Insurance and state regulatory requirements.• Experience supporting regulatory examinations, market conduct reviews, audits, or corrective action plans.• Experience leading cross-functional initiatives in a highly regulated healthcare environment.Your Skills/AbilitiesRegulatory ExpertiseStrong knowledge of Medicare, Medigap, and state insurance regulatory requirements, including Department of Insurance regulations and consumer protection standards.Analytical and Critical ThinkingAbility to interpret complex regulatory requirements and translate them into operationally actionable compliance obligations.Problem Solving SkillsStrong compliance risk assessment and problem-solving skills, with the ability to identify, evaluate, and escalate regulatory risks.Effective Written & Verbal CommunicationExcellent written and verbal communication skills, with the ability to effectively communicate regulatory requirements and compliance risks to various audiences, including senior leadership.Advisory & Consultative SkillsAbility to lead cross-functional initiatives and influence stakeholders across Compliance, Legal, Product, Operations, Claims, Enrollment, Marketing, and Member Services.Organizational & Time Management SkillsStrong ability to manage multiple priorities, work independently, make risk-based decisions and ability to manage competing demands in a dynamic, highly regulated environment.State Insurance Regulatory KnowledgeKnowledge of Washington and/or Oregon Department of Insurance regulations, regulatory processes, filings, examinations, and compliance requirements applicable to Medicare and Medigap products.Stakeholder Influence & Relationship ManagementAbility to influence and collaborate effectively across business units without direct authority, build consensus, navigate complex organizational dynamics, and drive compliance outcomes through partnership and effective communication.What's in it for you?Base Pay Range: $92,400 to $133,671 annuallyWork Mode: Mostly Onsite (In office 2 days per week on Tuesday/Wednesday)An annual employee bonus programRobust Wellness ProgramGenerous paid-time-off (PTO) along with 11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer daysExcellent 401(k) Retirement Saving Plan with employer matchRobust employee recognition programTuition reimbursementAn opportunity to become part of a team that makes a difference to our members and our community every day!We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.#LI-JA1#LI-HybridEqual Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)