Medicare Compliance Lead — Regulatory Expert, Remote

Centene Corporation; Oregon; Hybrid; USD 88,000 - 158,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Flexible work schedules

Job summary

Centene Corporation is seeking a Medicare Compliance Advisory expert to support day-to-day execution of the program in alignment with CMS requirements. You will provide regulatory guidance, conduct research, track issues, and support audit readiness while collaborating with leadership.

The role emphasizes translating complex federal/state requirements into actionable guidance, developing communications, and ensuring timely submissions of regulatory reports.

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.
• 4+ years Compliance advisory experience including regulatory research, drafting guidance, and risk assessment.
• 2+ years experience supporting managed care, Medicare Advantage/Part D, or DSNP programs.
• Foundational knowledge of Medicare regulations and CMS guidance.
• Strong written and verbal communication skills.
• Ability to manage multiple assignments and meet deadlines in a fast-paced environment.

Responsibilities

• Execute the Medicare Compliance Program in alignment with CMS and applicable federal and state regulations, ensuring prevention, detection, and correction of noncompliance and FWA.
• Interprets and translates federal, state, and contractual requirements into clear, actionable compliance guidance for business stakeholders.
• Develops regulatory communications and serves as liaison with regulators as appropriate.
• Supports preparation and submission of regulatory reports, attestations, and filings.
• Identify compliance risks, evaluate processes, and provide mitigation strategies.
• Lead or support root-cause analysis and corrective action plans for identified gaps.
• Provide SME support to audit and monitoring activities and assist in regulatory reviews.
• Collaborate with stakeholders to support audit execution and ongoing readiness.

Skills

Communication skills

Analytical skills

Time management

Education

Bachelor's degree in related field

Master's or JD preferred

Job description

Centene Corporation is seeking a Medicare Compliance Advisory expert to support day-to-day execution of the program in alignment with CMS requirements. You will provide regulatory guidance, conduct research, track issues, and support audit readiness while collaborating with leadership.

The role emphasizes translating complex federal/state requirements into actionable guidance, developing communications, and ensuring timely submissions of regulatory reports.