Remote Medicare Compliance Advisor - Clinical Care & Quality

Centene Corporation; Michigan; Hybrid; USD 88.000 - 158.000; Vollzeit

Benefits dieser Stelle

Health insurance

401K and stock purchase plans

Tuition reimbursement

PTO + holidays

Flexible work options: remote/hybrid/3

Zusammenfassung

Centene Corporation is seeking an experienced Medicare Compliance Advisory expert in the United States. This role acts as a subject matter expert for CMS and state regulations, guiding business stakeholders and supporting regulatory reporting, audits, and corrective actions.

The position emphasizes advisory support, risk assessment, and training, with flexible work options across remote, hybrid, field, or office environments. 5+ years in compliance and related fields are expected.

Qualifikationen

• Bachelor’s degree in a related field or equivalent experience required.
• 5+ years Compliance, regulatory, operations, or risk management in a regulated industry.
• 4+ years Compliance advisory experience including regulatory research and drafting guidance.
• 2+ years experience supporting managed care or Medicare 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.
• Certified in Healthcare Compliance (CHC) preferred.

Aufgaben

• Execute the Medicare Compliance Program in alignment with CMS and applicable regulations.
• Translate federal and state requirements into clear compliance guidance for stakeholders.
• Develop regulatory communications and disclosures with appropriate regulator liaison.
• Prepare, validate, and submit regulatory reports and attestations timely.
• Identify compliance risks, evaluate processes, and propose mitigations.
• Lead or support issue identification, root cause analysis, and corrective actions.
• Provide SME support to audit and monitoring activities and testing strategies.
• Collaborate with stakeholders to support audit execution and readiness.
• Evaluate remediation plans and validate corrective actions for sustainability.
• Contribute to training delivery and mentoring on regulatory requirements.
• Review policies and processes for regulatory alignment; drive cross-functional improvements.
• Monitor regulatory developments and industry trends to identify risks.

Kenntnisse

Regulatory research

Compliance advisory

Written communication

Analytical thinking

Multitasking

Ausbildung

Bachelor’s degree in a related field

Master’s Degree or Juris Doctor

Jobbeschreibung

Centene Corporation is seeking an experienced Medicare Compliance Advisory expert in the United States. This role acts as a subject matter expert for CMS and state regulations, guiding business stakeholders and supporting regulatory reporting, audits, and corrective actions.

The position emphasizes advisory support, risk assessment, and training, with flexible work options across remote, hybrid, field, or office environments. 5+ years in compliance and related fields are expected.