Medicare Compliance Project Manager

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

Benefits offered by this job

Annual bonus

Wellness program

PTO & holidays

401(k) match

Tuition reimbursement

Employee recognition

Job summary

SCAN Health Plan is seeking a Medicare Compliance Project Manager to lead audit readiness and coordinate regulatory audits (CMS and state regulators). The role ensures accurate, complete, defensible materials and manages CAPs from identification through closure.

The ideal candidate will coordinate cross-functional teams, track corrective actions, and maintain audit documentation while aligning with regulatory expectations. This position emphasizes collaboration, accuracy, and timely responses.

Qualifications

• Bachelor’s degree or equivalent combination of education and experience.
• 3–5 years of experience in healthcare compliance, auditing, regulatory affairs, risk management, project management, or related field.
• Experience coordinating complex projects involving multiple stakeholders and deadlines.
• Experience supporting audits, examinations, corrective action plans, or compliance oversight activities.
• Strong organizational, analytical, and communication skills.
• Experience supporting CMS Program Audits, Financial Audits, Validation Audits, or other regulatory reviews.
• Experience developing, tracking, validating, or monitoring corrective action plans (CAPs).
• Experience supporting compliance issue management, audit readiness, or regulatory response activities.
• Experience maintaining audit universes, evidence inventories, or regulatory documentation repositories.
• Project Management Professional (PMP), CHC, CCEP, or CIA preferred.

Responsibilities

• Audit Readiness Support – prepare and organize documentation, audit universes, and supporting evidence.
• Audit Universe Maintenance & Validation – review program audit universes for data integrity and gaps.
• Regulatory Audit Leadership & Coordination – lead coordination of audits from intake through close.
• Audit Documentation & Response Management – compile and submit audit documentation.
• CAP Development Support – document findings and assist with root cause analysis.
• CAP Tracking & Monitoring – track CAP activities and status updates.
• CAP Validation & Effectiveness Review – validate corrective actions and updated procedures.
• PCI Tracking – support intake and tracking of potential compliance issues.
• PCI to CAP Alignment – evaluate issues into formal CAPs.
• Audit Reporting & Committee Support – prepare status updates and dashboards.

Skills

Regulatory audits

Project management

CAP tracking

Analytical thinking

Communication

Relationship management

Regulatory knowledge

Data documentation

Education

Bachelor's Degree

Job description

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 $8billion 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.

The Job

The Medicare Compliance Project Manager supports and leads the organization’s regulatory audit readiness and execution activities, with a focus on external audits conducted by CMS and other federal and state regulators. They serve as a key coordination resource and central point of accountability for audit lifecycle management, including readiness preparation, audit response coordination, and corrective action plan (CAP) development, tracking, and validation. This role partners across business areas to ensure audit materials are accurate, complete, and defensible, and that compliance issues are consistently tracked, escalated, and resolved in alignment with regulatory expectations.

You Will

• Audit Readiness Support – Support enterprise audit readiness activities, including preparation and organization of documentation, maintenance of audit universes, and management of supporting evidence to ensure accuracy, completeness, and defensibility. Participate in readiness reviews and mock audit activities.
• Audit Universe Maintenance & Validation – Assist with quarterly review and validation of program audit universes to ensure data integrity, completeness, and alignment with CMS expectations. Identify gaps and coordinate updates with business owners.
• Regulatory Audit Leadership & Coordination – Lead coordination of regulatory audits (CMS, federal, and state) from intake through close, including tracking requests, managing deliverables, and facilitating communication across business areas to ensure timely and accurate responses.
• Audit Documentation & Response Management – Compile, review, and support submission of audit documentation to ensure consistency, clarity, and alignment with regulatory expectations.
• Corrective Action Plan (CAP) Development Support – Support development of CAPs by documenting findings, assisting with root cause analysis, and ensuring corrective actions align with regulatory expectations and internal standards.
• CAP Tracking & Monitoring – Track CAP activities through completion, maintain status updates, and follow up with business owners to support timely remediation and audit closure.
• CAP Validation & Effectiveness Review – Lead the internal validation process to confirm corrective actions have been fully implemented and are operating effectively. This includes conducting case file reviews, assessing updated policies and procedures, and evaluating training materials and supporting documentation to ensure sustained compliance and readiness for validation audits and closeout.
• Potential Compliance Issue (PCI) Tracking – Support intake and tracking of potential compliance issues identified through audits, monitoring activities, or other sources. Ensure issues are appropriately documented and escalated.
• PCI to CAP Alignment – Assist in evaluating and transitioning validated compliance issues into formal CAPs, ensuring consistency and alignment with compliance program processes.
• Audit Reporting & Committee Support – Prepare audit status updates, summaries, and materials for the Enterprise Compliance Committee and other governance forums. Develop and maintain audit readiness dashboards, status reports, risk logs, and project plans to support leadership visibility, regulatory readiness, and effective audit governance.

Your Qualifications

• Bachelor's Degree or equivalent combination of education and experience.
• 3‑5 years of experience in healthcare compliance, auditing, regulatory affairs, risk management, project management, or a related field.
• Experience coordinating complex projects involving multiple stakeholders and competing deadlines.
• Experience supporting audits, examinations, corrective action plans, or compliance oversight activities.
• Strong organizational, analytical, and communication skills.
• Experience supporting CMS Program Audits, Financial Audits, Validation Audits, or other federal or state regulatory reviews.
• Experience developing, tracking, validating, or monitoring corrective action plans (CAPs).
• Experience supporting compliance issue management, audit readiness, or regulatory response activities.
• Experience maintaining audit universes, evidence inventories, or regulatory documentation repositories.
• Project Management Professional (PMP), Certified Healthcare Compliance (CHC), Certified Compliance & Ethics Professional (CCEP), or Certified Internal Auditor (CIA) certification preferred.

Your Skills/Abilities

• Regulatory Audit Management – Ability to coordinate multiple regulatory audits simultaneously, manage audit deliverables, and ensure timely and accurate responses.
• Project Management – Strong organizational skills with the ability to manage competing priorities, deadlines, stakeholders, and dependencies.
• Corrective Action & Remediation Oversight – Ability to track, monitor, validate, and report remediation activities through completion.
• Analytical & Critical Thinking – Ability to analyze findings, identify root causes, evaluate evidence, and recommend practical solutions.
• Written & Verbal Communication – Ability to communicate effectively with leadership, regulators, auditors, and business stakeholders.
• Relationship Management – Ability to build credibility and foster productive working relationships across all levels of the organization.
• Regulatory Compliance Knowledge – Working knowledge of healthcare regulatory requirements, auditing principles, and compliance program expectations.
• Data Management & Documentation – Ability to maintain accurate documentation, audit inventories, evidence repositories, and reporting tools to support audit readiness and regulatory compliance.

What's in it for you?

• 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!

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;
• An opportunity to become part of a team that makes a difference to our members and our community every day!

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.

Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law.

A background check is required.

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.

41CFR60‑1.35(c)

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