Medicare Compliance Administrator

Job Summary

Supporting the Medicare Compliance Advisory program, the full-time Senior Compliance Administrator will manage regulatory guidance, conduct research and analysis, and ensure compliance with CMS and federal regulations while working remotely.

Key responsibilities

• Execute the Medicare Compliance Program to prevent, detect, and correct noncompliance and fraud, waste, and abuse (FWA)
• Interpret federal, state, and contractual requirements into actionable compliance guidance for stakeholders
• Support audit readiness and compliance activities by identifying risks and developing corrective action plans

Required qualifications

• Bachelor's degree in a related field or equivalent experience; Master's Degree or Juris Doctor preferred
• 5+ years of experience in compliance, regulatory, operations, or risk management within a regulated industry
• 4+ years of compliance advisory experience, including regulatory research and drafting compliance guidance
• 2+ years of experience supporting managed care or Medicare Advantage/Part D programs
• Foundational knowledge of Medicare regulations and CMS compliance expectations