Senior Medicare Compliance Advisor (Remote)

Centene Corporation; Connecticut; 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 and holidays

Flexible work schedules (remote/hybrid

Job summary

Centene Corporation is seeking a Medicare Compliance Advisory expert to support day-to-day operations of the program, aligning with CMS requirements and federal/state regulations. You will translate complex regulations into actionable guidance, prepare and validate regulatory reports, and help drive audit readiness across the organization.

You will analyze risks, lead root cause investigations, and collaborate with stakeholders to implement corrective actions and continuous improvements in

Qualifications

• Bachelor’s degree in a related field (e.g., healthcare administration, public health, policy) or equivalent experience required.
• Master’s Degree or Juris Doctor preferred.
• 5+ years Compliance, regulatory, operations, or risk management within a regulated industry.
• 4+ years Compliance advisory experience including regulatory research and drafting guidance, risk assessment, and audits.
• 2+ years experience with managed care or Medicare Advantage/Part D programs.
• Foundational knowledge of Medicare regulations and CMS guidance.

Responsibilities

• Execute the Medicare Compliance Program in alignment with CMS and state regulations, ensuring noncompliance and FWA prevention, detection, and correction.
• Translate federal, state, and contractual requirements into clear compliance guidance for business stakeholders.
• Develop and coordinate regulatory communications and disclosures, serving as liaison with regulators as appropriate.
• Support preparation, validation, and submission of regulatory reports and attestations.
• Identify compliance risks, assess processes, and recommend mitigation strategies.
• Lead or support root cause analysis and corrective action plans for identified gaps.
• Provide subject matter expertise to audits and monitoring activities and develop testing strategies.
• Collaborate with internal and external stakeholders to support audits and regulatory reviews.
• Evaluate remediation plans to ensure sustainable resolution and reporting requirements.

Skills

Regulatory research

Drafting guidance

Risk assessment

Audits & monitoring

Communication skills

Cross-functional collaboration

Education

Bachelor’s degree in related field

Master’s degree

Juris Doctor

Tools

MS Office

Regulatory databases

Job description

Centene Corporation is seeking a Medicare Compliance Advisory expert to support day-to-day operations of the program, aligning with CMS requirements and federal/state regulations. You will translate complex regulations into actionable guidance, prepare and validate regulatory reports, and help drive audit readiness across the organization.

You will analyze risks, lead root cause investigations, and collaborate with stakeholders to implement corrective actions and continuous improvements in