Senior Medicare Compliance Advisor - Remote

Centene Corporation; United States; Híbrido; USD 88.000 - 158.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance

401(k) plan

Stock purchase plan

Tuition reimbursement

Paid time off

Descripción de la vacante

Centene Corporation seeks a Medicare Compliance Advisor to support day-to-day execution of the Medicare Compliance Advisory program in alignment with CMS requirements and state regulations. You will provide regulatory guidance, conduct research, track issues, and support audit readiness while coordinating with leadership and stakeholders.

You will translate complex requirements into actionable guidance for business teams, prepare regulatory communications, and help ensure timely, accurate

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, issue tracking, auditing/monitoring, and corrective actions.
• 2+ years experience supporting managed care, Medicare Advantage/Part D, or DSNP programs.

Responsabilidades

• Execute the Medicare Compliance Program in alignment with CMS and regulations, ensuring prevention, detection, and correction of noncompliance and FWA.
• Translate federal, state, and contractual requirements into actionable compliance guidance for business stakeholders.
• Develop regulatory communications, including responses to inquiries and disclosures.
• Prepare, validate, and submit regulatory reports, attestations, and filings.
• Identify compliance risks and evaluate processes to assess exposure and mitigation.
• Lead or support root cause analysis and corrective action plans for gaps.
• Provide SME support to audit and monitoring activities including scope development and testing strategies.
• Collaborate with stakeholders to support audit execution and regulatory reviews.
• Evaluate remediation plans to ensure sustainable resolution of issues.
• Contribute to development and delivery of compliance training.
• Review policies and processes to ensure alignment with regulatory requirements.
• Drive cross-functional initiatives to improve compliance processes and efficiency.
• Monitor regulatory developments to identify emerging risks.
• Partner with compliance, legal, audit, and operations to coordinate activities across business areas.

Conocimientos

Regulatory research

Written and verbal communication

Analytical skills

Documentation skills

Multi-tasking

Regulatory experience in healthcare

Cross-functional collaboration

In-depth CMS knowledge

Educación

Bachelor’s degree in a related field

Master’s Degree or Juris Doctor preferred

Descripción del empleo

Centene Corporation seeks a Medicare Compliance Advisor to support day-to-day execution of the Medicare Compliance Advisory program in alignment with CMS requirements and state regulations. You will provide regulatory guidance, conduct research, track issues, and support audit readiness while coordinating with leadership and stakeholders.

You will translate complex requirements into actionable guidance for business teams, prepare regulatory communications, and help ensure timely, accurate