Medicare Compliance Advisor - Clinical Programs

Centene Management Company LLC; United States; Hybrid; USD 88,000 - 158,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedule (remote, hybrid

Job summary

Centene Management Company LLC is seeking a Senior Medicare Compliance Advisory expert to support day-to-day execution of the Medicare Compliance Advisory program in line with CMS requirements. You will provide regulatory guidance, perform research, track issues, and support audit readiness while coordinating with leadership and internal stakeholders.

The role involves translating federal and state requirements into actionable guidance, contributing to reporting, and helping identify risks with

Qualifications

• Bachelor’s degree in related field or equivalent experience required.
• 5+ years in Compliance, regulatory, operations, or risk management within a regulated industry.
• 4+ years in compliance advisory including regulatory research and drafting compliance guidance, assessing risk, issue tracking, auditing/monitoring, and overseeing the development and implementation of corrective action plans.
• 2+ years experience supporting managed care, Medicare Advantage/Part D, or Dual Eligible (DSNP) programs.
• Foundational knowledge of Medicare regulations, CMS guidance and compliance expectations; CHC preferred; CMS audit familiarity preferred.

Responsibilities

• Provide regulatory guidance to business and compliance leadership; support day-to-day Medicare Compliance Advisory program.
• Conduct regulatory research and analysis; track issues and support audit readiness.
• Translate CMS and state requirements into actionable guidance for stakeholders.
• Support submission of regulatory reports, attestations, and filings; ensure accuracy and timeliness.
• Identify compliance risks, evaluate processes, and suggest mitigations; support remediation and corrective actions.

Skills

Regulatory research

Drafting compliance guidance

Issue tracking

Auditing/Monitoring

Written and verbal communication

Analytical skills

Project management

Education

Bachelor's degree

Master’s Degree or JD preferred

Job description

Centene Management Company LLC is seeking a Senior Medicare Compliance Advisory expert to support day-to-day execution of the Medicare Compliance Advisory program in line with CMS requirements. You will provide regulatory guidance, perform research, track issues, and support audit readiness while coordinating with leadership and internal stakeholders.

The role involves translating federal and state requirements into actionable guidance, contributing to reporting, and helping identify risks with