Medicare Compliance Advisor (Remote) – Regulatory Risk & Audit

Centene Corporation; Lansing (MI); Vor Ort; USD 88.000 - 158.000; Vollzeit

Benefits dieser Stelle

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off & holidays

Flexible work arrangements

Zusammenfassung

Centene Corporation seeks an experienced subject matter expert to support the day-to-day execution of the Medicare Compliance Advisory program in alignment with CMS requirements and applicable federal and state regulations. The role provides advisory guidance, conducts regulatory research, tracks issues, and supports audit readiness across the organization.

This position partners with leadership to ensure accurate interpretation of CMS requirements, timely delivery of assignments, and

Qualifikationen

• Bachelor’s degree in healthcare administration, public health, policy or related field or equivalent experience.
• 5+ years in Compliance, regulatory, operations, or risk management within a regulated industry.
• 4+ years Compliance advisory experience including regulatory research, drafting compliance guidance, risk assessment, issue tracking, auditing/monitoring, and corrective action plans.
• 2+ years experience supporting managed care, Medicare Advantage/Part D, or DSNP programs.
• Foundational knowledge of Medicare regulations including CMS guidance and compliance expectations.

Aufgaben

• Support day-to-day execution of the Medicare Compliance Advisory program in alignment with CMS requirements and regulations.
• Provide regulatory guidance to business stakeholders and translate requirements into actionable guidance.
• Conduct research and analysis on CMS requirements and track regulatory trends.
• Contribute to audit readiness, attestations, and regulatory filings.
• Lead or support root cause analysis and development of corrective actions.
• Collaborate with internal/external stakeholders to support audits and regulatory reviews.

Kenntnisse

Regulatory guidance

Research & analysis

Issue tracking

Audit readiness

Medicare regulations

Ausbildung

Bachelor’s degree in related field

Master’s degree preferred

Juris Doctor (JD) preferred

Jobbeschreibung

Centene Corporation seeks an experienced subject matter expert to support the day-to-day execution of the Medicare Compliance Advisory program in alignment with CMS requirements and applicable federal and state regulations. The role provides advisory guidance, conducts regulatory research, tracks issues, and supports audit readiness across the organization.

This position partners with leadership to ensure accurate interpretation of CMS requirements, timely delivery of assignments, and