Senior Medicare Compliance Advisor

Centene Corporation; Springfield (IL); Hybrid; USD 88,000 - 158,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules (remote/hybrid

Job summary

Centene Corporation is seeking a Medicare Compliance Advisory subject matter expert to support day-to-day execution aligned with CMS requirements and federal/state regulations. You will partner with leadership to ensure timely, accurate guidance, issue tracking, and documentation of risks and corrective actions.

The role emphasizes providing regulatory research, communications, and audit readiness across business areas, with emphasis on collaboration and ongoing training development.

Qualifications

• Bachelor's degree or equivalent required; master's degree or JD preferred.
• 5+ years compliance, regulatory, operations, or risk management in regulated industries.
• 4+ years compliance advisory including regulatory research, drafting guidance, risk assessment, auditing/monitoring.
• 2+ years in managed care or Medicare programs (MA/Part D/DSNP).
• Foundational knowledge of Medicare regulations including CMS guidance (Parts C & D).
• Strong written and verbal communication; analytical and organizational skills.
• Ability to manage multiple assignments and deadlines in a fast-paced environment.

Responsibilities

• Execute Medicare Compliance Program per CMS and state regulations; ensure prevention, detection, and correction of noncompliance and FWA.
• Translate federal/state requirements into actionable guidance for stakeholders; ensure consistent understanding across operations.
• Prepare regulatory communications, responses to inquiries, issue summaries, and disclosures.
• Support submission of regulatory reports, attestations, filings with accuracy and timeliness.
• Identify compliance risks; evaluate processes for exposure; recommend mitigations.
• Lead or support root-cause analyses and corrective action plans.
• Provide SME for audits and monitoring; assist with scope development and testing strategies.
• Collaborate with stakeholders to support audits and regulatory reviews.
• Evaluate remediation plans to ensure sustainable corrective actions.
• Develop and deliver compliance training; mentor stakeholders on regulations and best practices.
• Review policies and procedures for regulatory alignment.
• Contribute to cross-functional initiatives to enhance compliance and efficiency.
• Monitor regulatory developments and industry trends; drive continuous improvement.
• Partner with compliance, legal, audit, and operations to coordinate activities.
• Perform other duties as assigned; comply with policies and standards.

Skills

Regulatory guidance

CMS requirements

Issue tracking

Audit support

Regulatory reporting

Policy review

Cross-functional collaboration

Communication skills

Education

Bachelor's degree

Master's degree preferred

Juris Doctor preferred

Job description

Centene Corporation is seeking a Medicare Compliance Advisory subject matter expert to support day-to-day execution aligned with CMS requirements and federal/state regulations. You will partner with leadership to ensure timely, accurate guidance, issue tracking, and documentation of risks and corrective actions.

The role emphasizes providing regulatory research, communications, and audit readiness across business areas, with emphasis on collaboration and ongoing training development.