Medicare Compliance Advisor | Remote/Hybrid

Centene Corporation; New York (NY); Hybrid; USD 88,000 - 158,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plan

Tuition reimbursement

Paid time off

Holidays

Flexible work arrangement

Job summary

Centene Corporation is seeking a Medicare Compliance Advisory subject matter expert to support day-to-day execution of CMS-aligned compliance activities in New York. You will provide regulatory guidance, perform research and issue tracking, and help ensure audit readiness while documenting risks and corrective actions.

The role collaborates with leadership to interpret CMS requirements, develop action plans, and communicate effectively with internal stakeholders and regulators.

Qualifications

• Bachelor's degree in a related field (e.g., healthcare administration, public health, policy) or equivalent experience required.
• 5+ years Compliance, regulatory, operations, or risk management within a regulated industry (e.g., healthcare, managed care, insurance, or public sector).
• 4+ years Compliance advisory experience including regulatory research and drafting compliance guidance, assessing risk, issue tracking, auditing/monitoring, and overseeing correction action plans.
• 2+ years experience supporting managed care, Medicare Advantage/Part D, or Dual Eligible (DSNP) programs.
• Foundational knowledge of Medicare regulations, including CMS guidance and compliance expectations (Parts C & D).
• Strong written and verbal communication skills.
• Strong analytical, organizational and documentation skills with attention to detail.
• Ability to manage multiple assignments and meet deadlines in a fast-paced environment.
• Certified in Healthcare Compliance (CHC) preferred.
• Familiarity with CMS audit protocols, program audits, or monitoring activities preferred.
• Experience in a matrixed or cross-functional environment preferred.

Responsibilities

• Execute the Medicare Compliance Program per CMS and state regulations to prevent, detect, and correct noncompliance and FWA.
• Translate federal, state, and contractual requirements into clear compliance guidance for business stakeholders.
• Develop regulatory communications and disclosures; liaise with regulators as appropriate.
• Support preparation and submission of regulatory reports, attestations, and filings.
• Identify compliance risks, assess exposure, and provide mitigation strategies.
• Lead or support root-cause analysis and corrective action plans.
• Provide SME support for audits and monitoring activities.
• Partner with stakeholders to support audit execution and regulatory reviews.
• Evaluate remediation plans and validate corrective actions.
• Contribute to development and delivery of compliance training.
• Review policies and processes for regulatory alignment.
• Lead or contribute to cross-functional initiatives to improve compliance.
• Monitor regulatory developments and industry trends.
• Collaborate with compliance, legal, audit, and operations for coordinated activities.
• Performs other duties as assigned.
• Complies with all policies and standards.

Skills

Regulatory guidance

Written communication

Verbal communication

Analytical

Documentation

Multitasking

Attention to detail

Education

Bachelor's degree in related field

Master's degree

Juris Doctor

Job description

Centene Corporation is seeking a Medicare Compliance Advisory subject matter expert to support day-to-day execution of CMS-aligned compliance activities in New York. You will provide regulatory guidance, perform research and issue tracking, and help ensure audit readiness while documenting risks and corrective actions.

The role collaborates with leadership to interpret CMS requirements, develop action plans, and communicate effectively with internal stakeholders and regulators.