Medicare Compliance Advisor & Audit Readiness Lead - Remote

Centene Corporation; Kansas City (MO); Hybrid; USD 88,000 - 158,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Flexible work schedules

Job summary

Centene Corporation is seeking an experienced Medicare Compliance Advisory expert to support day-to-day execution of the program in alignment with CMS requirements. You will interpret CMS guidance, provide regulatory analysis, and collaborate with leadership to address compliance risks and corrective actions.

The role emphasizes advisory support, issue tracking, and ongoing audit readiness across regulated initiatives, with exposure to CMS audits and cross-functional teams.

Qualifications

• Bachelor's degree in related field; advanced degree preferred.
• 5+ years of compliance, regulatory, operations, or risk management experience.
• 4+ years in compliance advisory, including regulatory research and drafting guidance.
• 2+ years in managed care, Medicare Advantage/Part D, or DSNP programs.
• Foundational knowledge of Medicare regulations and CMS guidance.
• Strong written and verbal communication; detail-oriented.
• CHC preferred.
• CMS audits or monitoring experience preferred.

Responsibilities

• Execute the Medicare Compliance Program per CMS and applicable regulations.
• Translate requirements into actionable guidance for stakeholders.
• Prepare regulatory reports, attestations, and filings.
• Identify risks, evaluate processes, and propose mitigations.
• Lead or support root cause analysis and corrective action plans.
• Support audit scope, testing strategies, and ongoing compliance oversight.
• Collaborate with stakeholders for audits and regulatory reviews.
• Validate remediation and ensure sustainable fixes.
• Develop and deliver compliance training.
• Review policies to ensure regulatory alignment.
• Lead cross-functional initiatives to improve compliance.
• Monitor regulatory developments and industry trends.
• Coordinate with legal, audit, and operations for compliance activities.
• Perform other duties and comply with policies.

Skills

Regulatory research

Drafting guidance

Issue tracking

Auditing & monitoring

Corrective action

Cross-functional collab

Regulatory reporting

Education

Bachelor's degree in related field

Master's degree or JD preferred

Job description

Centene Corporation is seeking an experienced Medicare Compliance Advisory expert to support day-to-day execution of the program in alignment with CMS requirements. You will interpret CMS guidance, provide regulatory analysis, and collaborate with leadership to address compliance risks and corrective actions.

The role emphasizes advisory support, issue tracking, and ongoing audit readiness across regulated initiatives, with exposure to CMS audits and cross-functional teams.