Senior Medicare Compliance Lead (Part C/D)

Blue Cross and Blue Shield of Kansas Inc.; Chicago (IL); Hybrid; USD 114,000 - 154,000; Full time

Benefits offered by this job

Annual bonus incentive pay

Comprehensive benefits

Job summary

Blue Cross and Blue Shield of Kansas Inc. is seeking a Compliance Lead for Government Programs to partner with the Medicare Compliance Officer in executing and maturing the CMS-aligned compliance program across Part C and Part D.

The role translates complex regulations into practical processes and helps embed compliance into daily operations. Responsibilities include risk assessment, training, monitoring, audits, and issue remediation, with liaison duties to operational teams and boards.

Qualifications

• Deep knowledge of CMS Medicare regulations and guidance.
• Ability to operationalize the 7 Elements of an Effective Compliance Program across Part C and Part D.
• Experience with Medicare Part D and MA-PD program requirements including enrollment and claims.
• Understanding FWA requirements and detection methodologies.

Responsibilities

• Support the Medicare Compliance Officer in executing and improving the compliance program.
• Provide SME in Part C and Part D operations and assess compliance risks across core areas.
• Serve as primary liaison to operational teams ensuring regulatory alignment.
• Translate regulatory requirements into actionable operational processes.
• Support ongoing risk assessment activities through audits, FDR monitoring, and committee reporting.

Skills

CMS Medicare regulations

7 Elements of Compliance

FWA knowledge

Regulatory gap analyses

Auditing & monitoring

CAPs

Policy development

Training & education

Cross-functional liaison

Board-level reporting

Education

BS

Tools

CMS audit protocols

Job description

Blue Cross and Blue Shield of Kansas Inc. is seeking a Compliance Lead for Government Programs to partner with the Medicare Compliance Officer in executing and maturing the CMS-aligned compliance program across Part C and Part D.

The role translates complex regulations into practical processes and helps embed compliance into daily operations. Responsibilities include risk assessment, training, monitoring, audits, and issue remediation, with liaison duties to operational teams and boards.