Senior Medicare Compliance Advisor (Remote)

Centene Corporation; United States; 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 schedules (remote,Hybrid

Job summary

Centene Corporation seeks an expert in Medicare Compliance Advisory to support the day‑to‑day execution of the program in line with CMS requirements and federal/state regulations. You will provide advisory support to business and compliance leadership, conduct regulatory research, track issues, and assist with audits and regulatory filings.

The role partners with the Sr. Manager, Medicare Compliance Advisory to ensure accurate interpretation of CMS requirements, timely completion of assignments,

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.
• 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 correction action plans required.
• 2+ years experience supporting managed care, Medicare Advantage/Part D, or Dual Eligible 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.
• Certified in Healthcare Compliance (CHC) preferred.
• Familiarity with CMS audit protocols, program audits, or monitoring activities preferred.
• Experience working in a matrixed or cross-functional environment preferred.

Responsibilities

• Execute the Medicare Compliance Program in alignment with CMS and applicable regulations, ensuring prevention, detection, and correction of noncompliance and FWA.
• Translate federal, state, and contractual requirements into clear compliance guidance for stakeholders.
• Develop regulatory communications and serve as liaison with regulators as appropriate.
• Prepare, validate, and submit regulatory reports, attestations, and filings with accuracy and timeliness.
• Identify compliance risks, evaluate processes, and provide mitigation guidance.
• Lead or support root cause analysis and corrective action plan development.
• Provide SME support to audits and monitoring activities, including scope development and testing strategies.
• Collaborate with stakeholders to support audit execution and regulatory reviews.
• Evaluate remediation plans and validate corrective actions for sustainable resolution.
• Contribute to training development and deliver regulatory training to stakeholders.
• Review policies and processes to align with regulatory requirements.
• Lead cross-functional initiatives to enhance compliance processes and efficiency.
• Monitor regulatory developments and industry trends to identify risks.
• Collaborate with compliance, legal, audit, and operations for coordinated activities.
• Performs other duties as assigned and comply with policies.

Skills

Regulatory research

Drafting guidance

Issue tracking

Audit readiness

Cross-functional

CMS knowledge

Compliance interpretation

Attention to detail

Education

Bachelor's degree

Master's degree preferred

Juris Doctor preferred

Job description

Centene Corporation seeks an expert in Medicare Compliance Advisory to support the day‑to‑day execution of the program in line with CMS requirements and federal/state regulations. You will provide advisory support to business and compliance leadership, conduct regulatory research, track issues, and assist with audits and regulatory filings.

The role partners with the Sr. Manager, Medicare Compliance Advisory to ensure accurate interpretation of CMS requirements, timely completion of assignments,