Medicare Programs Compliance Specialist

Health Care Service Corporation; Nashville (TN); On-site; USD 62,000 - 136,000; Full time

Job summary

Health Care Service Corporation (HCSC) is seeking a regulatory compliance professional to evaluate Medicare/ CMS guidance, identify risks, and act as SME across internal operations and FDRs. You will partner with business units, government agencies, and other compliance colleagues to implement effective remediation strategies.

This role requires strong communication, analytical, and risk-mitigation skills, with a proven ability to work independently and manage multiple regulatory workstreams in

Qualifications

• Bachelor’s degree and 3 years’ experience in health plans, regulatory compliance or risk management OR 6 years’ experience in health plans, regulatory compliance, or risk management
• Ability to communicate with and build relationships with internal business units and/or various external government agencies
• Critical thinking, risk assessment, and mitigation
• Verbal and written communication skills
• Ability to work with minimal supervision
• Organizational, analytical, and decision-making skills
• PC proficiency to include Word, PowerPoint, and Excel

Responsibilities

• Evaluate Medicare regulatory requirements and CMS guidance to assess compliance risks
• Serve as SME to assist in evaluation and ensure regulatory requirements implemented across internal operations and assigned FDRs
• Oversee operational compliance through universe and report reviews, attendance at operational meetings, and targeted monitoring of high‑risk areas of concern
• Identify, assess, and escalating compliance risks and issues; develop and monitor mitigation and remediation strategies

Skills

Regulatory compliance

Risk assessment

Communication

Stakeholder management

Microsoft Office

Education

Bachelor’s degree in health plans/regulatory compliance or related field

Tools

Word

PowerPoint

Excel

Job description

Health Care Service Corporation (HCSC) is seeking a regulatory compliance professional to evaluate Medicare/ CMS guidance, identify risks, and act as SME across internal operations and FDRs. You will partner with business units, government agencies, and other compliance colleagues to implement effective remediation strategies.

This role requires strong communication, analytical, and risk-mitigation skills, with a proven ability to work independently and manage multiple regulatory workstreams in