Remote Senior Medicare Compliance Advisor

Centene Corporation; Missouri; Hybrid; USD 88,000 - 158,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work arrangements

Job summary

Centene Corporation seeks a Medicare Compliance Advisory expert to support day-to-day execution of the program, translating CMS requirements into actionable guidance for stakeholders and ensuring timely regulatory deliverables.

The role partners with leadership to monitor risks, drive corrective actions, and support audits while maintaining documentation and training across the organization.

Qualifications

• Bachelor’s degree in a related field or equivalent experience required. Master’s Degree or Juris Doctor preferred.
• 5+ years Compliance, regulatory, operations, or risk management within a regulated industry (e.g., healthcare, managed care, insurance, or public sector).
• 4+ years Compliance advisory experience including regulatory research and drafting compliance guidance, assessing risk, issue tracking, auditing/monitoring, and overseeing development and implementation of corrective action plans.
• 2+ years experience supporting managed care, Medicare Advantage/Part D, or Dual Eligible (DSNP) programs.
• Foundational knowledge of Medicare regulations, including CMS guidance and compliance expectations (e.g., Parts C & D).
• Strong written and verbal communication skills.
• Strong analytical, organizational and documentation skills with attention to detail.
• Ability to manage multiple assignments and meet deadlines in a fast-paced environment.

Responsibilities

• Execute the Medicare Compliance Program in alignment with CMS and state regulations, ensuring prevention, detection, and correction of noncompliance and FWA.
• Translate federal, state, and contractual requirements into clear, actionable compliance guidance for business stakeholders.
• Develop regulatory communications, including responses to inquiries, issue summaries, and disclosures, liaising with regulators as appropriate.
• Support the preparation, validation, and submission of regulatory reports, attestations, and filings.
• Identify compliance risks and evaluate business processes to assess exposure, provide risk stratification, and recommend mitigation strategies.
• Lead or support root cause analysis and development of corrective action plans for gaps.
• Provide SME to audit and monitoring activities, including testing strategies and oversight.
• Collaborate with internal and external stakeholders to support audit execution and regulatory reviews.
• Evaluate remediation plans and validate corrective actions for sustainable resolution.
• Contribute to development and delivery of compliance training and mentor stakeholders.
• Review policies and procedures to ensure alignment with regulatory requirements.
• Lead cross-functional initiatives to enhance compliance processes and operational efficiency.
• Monitor regulatory developments and industry trends for emerging risks.
• Collaborate with compliance, legal, audit, and operations for coordinated activities.
• Performs other duties as assigned.
• Complies with all policies and standards.

Skills

Regulatory compliance

Regulatory research

Policy interpretation

Stakeholder communication

Audit support

Project management

Documentation

Education

Bachelor’s degree in a related field

Master’s Degree or JD preferred

Job description

Centene Corporation seeks a Medicare Compliance Advisory expert to support day-to-day execution of the program, translating CMS requirements into actionable guidance for stakeholders and ensuring timely regulatory deliverables.

The role partners with leadership to monitor risks, drive corrective actions, and support audits while maintaining documentation and training across the organization.