Medicare Compliance Advisor: Grievances & Privacy

Centene Corporation; Hartford (CT); 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

Job summary

Centene Corporation is seeking an experienced Medicare Compliance Advisory expert to lead and support day-to-day regulatory activities.

The role provides advisory support to leadership, conducts regulatory research, tracks issues, and ensures timely, accurate documentation of risks and corrective actions. Collaboration with internal teams and regulators is essential to maintain audit readiness and program integrity.

Qualifications

• Bachelor’s degree or equivalent required in healthcare administration, public health, policy or related field.
• Master’s or JD preferred depending on role seniority.
• 5+ years in Compliance, regulatory, operations, or risk management in regulated industries.
• 2+ years experience in managed care, Medicare Advantage/Part D, or DSNP programs.
• Foundational knowledge of Medicare regulations (CMS guidance).

Responsibilities

• Execute the Medicare Compliance Program in alignment with CMS and regulations to prevent, detect, and correct noncompliance and FWA.
• Translate federal, state, and contractual requirements into actionable guidance for business stakeholders.
• Prepare, validate, and submit regulatory reports, attestations, and filings.
• Identify compliance risks, evaluate processes, and recommend mitigations.
• Support audit scope development, testing strategies, and ongoing monitoring.

Skills

Regulatory research

Drafting compliance guidance

Audit & monitoring

Issue tracking

Cross-functional collaboration

Communication skills

Education

Bachelor’s degree in a related field

Master’s Degree or Juris Doctor preferred

Job description

Centene Corporation is seeking an experienced Medicare Compliance Advisory expert to lead and support day-to-day regulatory activities.

The role provides advisory support to leadership, conducts regulatory research, tracks issues, and ensures timely, accurate documentation of risks and corrective actions. Collaboration with internal teams and regulators is essential to maintain audit readiness and program integrity.