Medigap & MAPD Compliance Lead

SCAN; Long Beach (CA); On-site; USD 92,000 - 134,000; Full time

Benefits offered by this job

Annual bonus program

Wellness Program

Generous PTO + holidays

401(k) with employer match

Tuition reimbursement

Job summary

SCAN is seeking a Medigap Compliance Program Manager to oversee Medicare Advantage, Medigap, and state regulatory requirements across senior health programs. You will partner with Legal Affairs and operations to implement, monitor, and maintain regulatory controls, translating complex rules into practical guidance for the business.

You will lead cross-functional efforts, support regulatory reviews, and develop policies to ensure sustainable compliance while supporting SCAN’s mission and member

Qualifications

• Bachelor's degree or equivalent combination of education and experience.
• 5+ years of healthcare compliance, regulatory affairs, audit, risk management, Medicare, Medigap, or related experience.
• Experience interpreting and implementing federal and state regulatory requirements.
• Experience conducting compliance risk assessments and providing regulatory guidance to business stakeholders.
• Experience supporting regulatory examinations, audits, investigations, or corrective action activities.
• Medicare Advantage, Part D, and/or Medigap experience.
• Experience working with state Departments of Insurance and state regulatory requirements.
• Experience supporting regulatory examinations, market conduct reviews, audits, or corrective action plans.
• Experience leading cross-functional initiatives in a highly regulated healthcare environment.

Responsibilities

• Oversee assigned Medigap and state regulatory affairs compliance domains, partnering with business stakeholders to ensure regulatory requirements are implemented, monitored, and maintained.
• Monitor federal and state regulatory requirements with Legal Affairs and operations partners to assess impact and clarify expectations.
• Serve as the subject matter expert on Medigap requirements including guaranteed issue rules and enrollment rights.
• Assess how Medigap regulation changes impact Medicare Advantage enrollment, member behavior, and business strategy.
• Coordinate the implementation of Department of Insurance regulatory requirements across business areas; ensure timely compliance.
• Support regulatory examinations, audits, inquiries, and market conduct reviews and coordinate responses.
• Lead interpretation of evolving requirements; translate guidance into clear compliance expectations for business areas.
• Recommend new/revised compliance policies, standards, and controls to sustain compliance in a changing environment.
• Provide compliance guidance and education through training materials, presentations, and sessions; maintain independence from training administration.
• Partner with units to facilitate implementation of compliance requirements and elevate risks.

Skills

Medicare compliance

Regulatory interpretation

Cross-functional collaboration

Regulatory risk assessment

Education

Bachelor's degree or equivalent

Job description

SCAN is seeking a Medigap Compliance Program Manager to oversee Medicare Advantage, Medigap, and state regulatory requirements across senior health programs. You will partner with Legal Affairs and operations to implement, monitor, and maintain regulatory controls, translating complex rules into practical guidance for the business.

You will lead cross-functional efforts, support regulatory reviews, and develop policies to ensure sustainable compliance while supporting SCAN’s mission and member