Medicare Compliance Advisor - Risk & Regulatory Guidance

Centene Corporation; Athens (GA); Hybrid; USD 110,000 - 150,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Remote/hybrid/field or office work

Job summary

Centene Corporation seeks an experienced professional to support the day-to-day execution of the Medicare Compliance Advisory program in alignment with CMS requirements and applicable federal and state regulations. This role provides advisory support to business and compliance leadership, conducts research and analysis, tracks issues, and supports audit readiness and workplan activities.

The position focuses on interpreting CMS guidance, developing regulatory communications, and ensuring timely,

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.

Responsibilities

• Execute the Medicare Compliance Program in alignment with CMS and regulations, ensuring prevention, detection and correction of noncompliance and FWA.
• Interprets and translates requirements into clear, actionable guidance for business stakeholders.
• Supports regulatory reports, attestations, and filings for accuracy and timeliness.
• Identifies compliance risks, evaluates processes, and recommends mitigation strategies.
• Leads or supports root cause analysis and corrective action plans.

Skills

Regulatory compliance

CMS guidance

Regulatory research

Risk management

Auditing/monitoring

Education

Bachelor’s degree in related field

Job description

Centene Corporation seeks an experienced professional to support the day-to-day execution of the Medicare Compliance Advisory program in alignment with CMS requirements and applicable federal and state regulations. This role provides advisory support to business and compliance leadership, conducts research and analysis, tracks issues, and supports audit readiness and workplan activities.

The position focuses on interpreting CMS guidance, developing regulatory communications, and ensuring timely,