Medicare Compliance Advisory Lead

Centene Corporation; Atlanta (GA); Hybrid; USD 110,000 - 170,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work arrangements (remote/hyb

Field or office work schedules

Job summary

Centene Corporation seeks a subject matter expert to advance the Medicare Compliance Advisory program, ensuring CMS-aligned guidance, timely reporting, and proactive risk mitigation. The role partners with compliance, legal, and operations to sustain audit readiness and effective corrective actions.

You will interpret complex requirements, develop clear guidance for business units, and support training to strengthen enterprise-wide compliance controls and governance.

Qualifications

• Bachelor’s degree required in a related field.
• 5+ years in Compliance, regulatory, operations, or risk within a regulated industry.
• ~4+ years Compliance advisory experience including regulatory research and drafting compliance guidance, assessing risk, issue tracking, auditing/monitoring, and overseeing corrective action plans.
• Foundational knowledge of Medicare regulations, CMS guidance and compliance expectations (Parts C & D).
• Certified in Healthcare Compliance (CHC) preferred.
• Familiarity with CMS audit protocols, program audits, or monitoring activities preferred.

Responsibilities

• Execute the Medicare Compliance Program in alignment with CMS and state regulations to prevent, detect, and correct noncompliance and FWA.
• Translate federal, state, and contractual requirements into clear, actionable guidance for business stakeholders.
• Develop regulatory communications, responses to inquiries, and disclosures, coordinating with regulators as needed.
• Support preparation, validation, and submission of regulatory reports, attestations, and filings.
• Identify compliance risks, evaluate business processes, and recommend mitigation strategies.
• Lead or support root-cause analysis and corrective action plans for identified gaps.
• Provide SME support to audits and monitoring activities, including scope development and testing strategies.
• Collaborate with internal and external stakeholders to ensure audit readiness and regulatory reviews.

Education

Bachelor's degree

Job description

Centene Corporation seeks a subject matter expert to advance the Medicare Compliance Advisory program, ensuring CMS-aligned guidance, timely reporting, and proactive risk mitigation. The role partners with compliance, legal, and operations to sustain audit readiness and effective corrective actions.

You will interpret complex requirements, develop clear guidance for business units, and support training to strengthen enterprise-wide compliance controls and governance.