Medicare Compliance Program Manager

GRP SCAN Group; California (MO); Hybrid; USD 92,000 - 134,000; Full time

Benefits offered by this job

Annual bonus program

Generous PTO and holidays

401(k) with employer match

Wellness program

Job summary

SCAN seeks a skilled Compliance Program Lead to drive administration, technology enablement, and process improvements across our national regulatory framework.

You will partner with compliance, operations, and IT teams to implement AI-powered solutions, develop dashboards, and ensure regulatory requirements are effectively monitored and documented.

Qualifications

• Bachelor's Degree in Healthcare Administration, Business Administration, Information Systems, Compliance, Public Health, Health Informatics, Project Management, or related field (or equivalent).
• 5+ years of progressive healthcare compliance, Medicare Advantage, regulatory operations, program administration, or related field.
• Experience leading cross-functional initiatives and managing complex projects.
• Experience gathering requirements, designing dashboards, and supporting system implementations.
• Strong knowledge of Medicare Advantage, Part D, CMS regulations, or similarly regulated environments.

Responsibilities

• Lead compliance program administration and strategy to strengthen effectiveness and scalability.
• Identify opportunities to leverage technology, automation, and AI for compliance.
• Support implementation and continuous improvement of compliance tech platforms.
• Coordinate regulatory implementation and change management with stakeholders.
• Serve as liaison between Compliance, operations, and technology teams.

Skills

Medicare Advantage

CMS regulations

Data analytics

Cross-functional leadership

Project management

Regulatory compliance

Education

Bachelor's Degree in Healthcare Administration

Tools

Analytics & Reporting tools

Job description

About SCAN

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do. Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity. At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.

Job Overview

The Job Leads compliance program administration, technology enablement, process improvement, analytics, and regulatory implementation activities that support the effectiveness and maturity of the Compliance Program. Partners with Compliance, business operations, and technology teams to ensure regulatory requirements are effectively implemented, monitored, and documented while identifying opportunities to leverage technology, workflow automation, data analytics, and artificial intelligence to strengthen program oversight, operational efficiency, and regulatory compliance

Key Responsibilities

• Compliance Program Administration & Strategy- Lead and support compliance program administration activities, initiatives, and projects designed to strengthen the effectiveness, scalability, and maturity of the Compliance Program. Focus areas include policies and procedures, training and education, departmental communications, compliance investigations, reporting, etc.
• Technology, Automation & AI Enablement- Identify opportunities to leverage technology, analytics, workflow automation, and artificial intelligence to improve Compliance Program effectiveness, operational efficiency, and regulatory compliance. Work with stakeholders to define and translate business requirements into systems specifications.
• Compliance Technology & Systems- Support the implementation, optimization, administration, and continuous improvement of compliance technology platforms, reporting solutions, regulatory libraries, and workflow management tools.
• Regulatory Implementation & Change Management- Coordinate and monitor implementation of federal and state regulatory requirements, ensuring actions are assigned, tracked, documented, and completed in collaboration with Compliance and business stakeholders.
• Cross-Functional Program Leadership- Serve as a liaison between Compliance, business operations, and technology teams to facilitate successful project execution, regulatory implementation, and program initiatives.
• Process Improvement- Analyze compliance and operational processes to identify opportunities for standardization, optimization, automation, and continuous improvement.
• Data Analytics & Reporting- Develop and maintain dashboards, reports, metrics, and data-driven insights that support compliance oversight, program performance monitoring, and leadership decision-making.
• Business Requirements & Solution Design- Translate regulatory, compliance, and business requirements into implementation plans, process improvements, system enhancements, and technology-enabled solutions.
• Governance & Stakeholder Support- Facilitate workgroups, stakeholder meetings, and governance activities; monitor project milestones, risks, dependencies, and implementation outcomes.
• Change Management & Adoption- Develop implementation documentation, training materials, communication plans, and user adoption strategies to support successful deployment of program initiatives and technology solutions.

We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.

Actively support the achievement of SCAN’s Vision and Goals.

Other duties as assigned.

Your Qualifications

• Bachelor's Degree in Healthcare Administration, Business Administration, Information Systems, Compliance, Public Health, Health Informatics, Project Management, or a related field, or equivalent combination of education and experience
• 5+ years of progressive experience in healthcare compliance, Medicare Advantage, regulatory operations, program administration, business systems, technology implementation, project management, or a related field.
• Demonstrated experience leading cross-functional initiatives, managing complex projects, and driving business process improvements required.
• Experience gathering business and technical requirements, coordinating user acceptance testing, developing reports, dashboards, and analytics, and supporting system implementations and enhancements required.
• Strong knowledge of Medicare Advantage, Part D, CMS regulations, or another highly regulated environment required.
• Experience leveraging technology, workflow automation, analytics, and/or emerging technologies to improve operational efficiency and program effectiveness preferred.
• Strong knowledge of Medicare Advantage, Part D, healthcare compliance, and regulatory requirements.
• Ability to translate regulatory and business requirements into actionable implementation plans, process improvements, and technology-enabled solutions
• Strong project and program management skills, including the ability to lead cross-functional initiatives and drive accountability without direct authority.
• Demonstrated analytical and problem-solving skills, with the ability to interpret data, identify trends, and support informed decision-making.
• Proficiency with technology, reporting, workflow automation, and emerging technologies, including artificial intelligence and data analytics
• Excellent verbal and written communication skills, with the ability to effectively engage stakeholders at all levels of the organization
• Ability to manage multiple priorities in a fast-paced environment while maintaining attention to detail and meeting deadlines
• Strong collaboration and relationship-building skills with the ability to work effectively across business, operational, and technical teams.

Your Skills/Abilities

• Base Pay Range: $92,400 to $133,671 annually
• Work Mode: Mostly Onsite (In office 2 days per week on Tuesday/Wednesday)
• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO) along with 11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer days
• Excellent 401(k) Retirement Saving Plan with employer match
• Robust employee recognition program
• Tuition reimbursement

An opportunity to become part of a team that makes a difference to our members and our community every day! We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now! At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more. SCAN is proud to be an Equal Employment Opportunity and Aff…

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)

Become part of a mission-driven team that makes a difference in the lives of seniors every day. SCAN has a long history of finding and investing in ways to meet seniors' needs. This focus is what attracts employees to SCAN. For each and every one of us, the SCAN mission is personal. Keeping Seniors Healthy and Independent is both our mission and our passion. That same commitment carries over to our employees. We provide the training, tools and support necessary to do your work. We reward effort and celebrate success. SCAN both develops and attracts people who are leading experts in their respective fields. If the SCAN mission is one you believe in too, we invite you to explore the career opportunities at SCAN.

Why consider a career at SCAN? - A competitive compensation and benefits program; - An annual employee bonus program; - Generous paid-time-off (PTO); - Eleven paid holidays per year; - Excellent Retirement Savings program; - A work-life balance; and - An opportunity to become part of a team that makes a difference to our members and our community every day!

Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities

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