Remote Senior Medicare Compliance Specialist

Centene Corporation; Connecticut; Remote; USD 88.000 - 158.000; Vollzeit

Benefits dieser Stelle

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Flexible work arrangements

Zusammenfassung

Centene Corporation is seeking an expert for Medicare Compliance Advisory to support day-to-day execution of CMS-aligned programs. The role provides regulatory guidance, conducts research, tracks issues, and supports audit readiness and workplan activities across the organization.

As a subject matter expert, you will interpret CMS requirements, liaise with regulators, and help develop corrective actions while ensuring timely, accurate documentation and risk mitigation for managed care

Qualifikationen

• Bachelor’s degree in healthcare administration, public health, policy, or related field.
• 5+ years of Compliance, regulatory, operations, or risk management within a regulated industry.
• 2+ years experience supporting managed care, Medicare Advantage/Part D, or DSNP programs.

Aufgaben

• Execute the Medicare Compliance Program in alignment with CMS and applicable federal and state regulations, ensuring prevention, detection, and correction of noncompliance and FWA.
• Interprets and translates federal, state, and contractual requirements into clear, actionable compliance guidance for business stakeholders.
• Supports the preparation, validation, and submission of regulatory reports, attestations, and filings, ensuring accuracy and timeliness.
• Leads or supports issue identification, root cause analysis, and development of corrective action plans to ensure compliant resolution of gaps.
• Provides subject matter expertise to audit and monitoring activities, including testing strategies and ongoing compliance oversight.
• Collaborates with compliance, legal, audit, and operations partners to ensure coordinated execution of compliance activities.

Kenntnisse

Regulatory research

Compliance guidance

Auditing support

Documentation

Ausbildung

Bachelor's degree

Master's degree preferred

Jobbeschreibung

Centene Corporation is seeking an expert for Medicare Compliance Advisory to support day-to-day execution of CMS-aligned programs. The role provides regulatory guidance, conducts research, tracks issues, and supports audit readiness and workplan activities across the organization.

As a subject matter expert, you will interpret CMS requirements, liaise with regulators, and help develop corrective actions while ensuring timely, accurate documentation and risk mitigation for managed care