Senior Medicare Compliance Advisor (Remote)

Centene Corporation; Springfield (IL); Híbrido; USD 88.000 - 158.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Competitive pay

Health insurance

401K plans

Stock purchase plans

Tuition reimbursement

Paid time off + holidays

Flexible work arrangements

Descripción de la vacante

Centene Corporation is seeking a Medicare Compliance Advisory expert to support day-to-day operations, assess regulatory requirements, and provide trusted guidance to business leaders. You will drive issue tracking, risk assessment, and corrective action planning to ensure compliant, timely deliverables.

The role requires deep CMS knowledge, strong communication, and experience in audits or monitoring within a regulated healthcare environment.

Formación

• 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 (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 the 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, CMS guidance and compliance expectations (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.
• CHC certification preferred.
• Familiarity with CMS audit protocols, program audits, or monitoring activities preferred.
• Experience working in a matrixed or cross-functional environment preferred.

Responsabilidades

• Serves as an SME supporting the day-to-day execution of the Medicare Compliance Advisory program in alignment with CMS requirements and regulations.
• Provides regulatory guidance, conducts research and analysis, tracks issues, and contributes to audit readiness and compliance workplans.
• Executes the Medicare Compliance Program, ensuring prevention, detection, and correction of noncompliance and FWA.
• Interprets federal, state, and contractual requirements into clear, actionable compliance guidance for stakeholders.
• Develops regulatory communications and serves as liaison with regulators as appropriate.
• Supports preparation, validation, and submission of regulatory reports, attestations, and filings.
• Identifies compliance risks, evaluates processes, and recommends mitigation strategies.
• Leads or supports root-cause analysis and corrective action plans; supports audits and monitoring activities.
• Collaborates with compliance, legal, audit, and operations to ensure coordinated execution; monitors developments and trends.

Conocimientos

Regulatory guidance

Regulatory research

Issue tracking

Audit readiness

Communication skills

Analytical skills

Educación

Bachelor's degree

Master's degree or JD preferred

CHC certification preferred

Descripción del empleo

Centene Corporation is seeking a Medicare Compliance Advisory expert to support day-to-day operations, assess regulatory requirements, and provide trusted guidance to business leaders. You will drive issue tracking, risk assessment, and corrective action planning to ensure compliant, timely deliverables.

The role requires deep CMS knowledge, strong communication, and experience in audits or monitoring within a regulated healthcare environment.