Senior Medicare Compliance Advisor - Remote & Audit-Ready

Centene Corporation; Springfield (IL); 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 and holidays

Remote, hybrid, field or office work

Job summary

Centene Corporation is seeking 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, partnering with leadership to document risks and corrective actions.

You will translate requirements for business stakeholders, develop regulatory communications, and assist in timely regulatory reporting.

Qualifications

• Bachelor's degree in a related field (e.g., healthcare administration, public health, policy) or equivalent experience required.
• 5+ years Compliance, regulatory, operations, or risk management within a regulated industry.
• 4+ years Compliance advisory experience including regulatory research and drafting compliance guidance, risk assessment, and tracking.
• 2+ years experience supporting managed care, Medicare Advantage/Part D, or DSNP programs.

Responsibilities

• 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 and serve as liaison with regulators as appropriate.
• Support preparation, validation, and submission of regulatory reports and filings.
• Identify compliance risks, evaluate processes, and recommend mitigation strategies.
• Lead or support root-cause analysis and corrective action plans for identified gaps.
• Provide SME to audit and monitoring activities, including scope development and testing strategies.
• Collaborate with stakeholders to support audit execution and regulatory reviews.

Skills

Regulatory interpretation

Advisory support

CMS guidance

Regulatory research

Education

Bachelor's degree

Master's or JD preferred

Job description

Centene Corporation is seeking 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, partnering with leadership to document risks and corrective actions.

You will translate requirements for business stakeholders, develop regulatory communications, and assist in timely regulatory reporting.