Medicare Compliance Program Manager

Job Summary

Managing Medicare Advantage compliance activities, the full-time remote Medicare Compliance Program Manager will oversee compliance operations, regulatory affairs, and the development of training programs while ensuring adherence to federal and state regulations.

Key responsibilities

• Analyze business needs and collaborate with internal and external partners to address compliance issues and implement corrective actions
• Ensure timely submissions of CMS-required documents and maintain communication channels for reporting compliance concerns
• Develop and manage training programs for employees and vendors to ensure compliance with the Medicare Advantage Compliance Program and relevant laws

Required qualifications

• Bachelor's degree required; Master's degree in a related field preferred
• Minimum seven years of government compliance experience in healthcare insurance or CMS programs, or five years with a relevant Master's degree and certification
• At least three years of direct Medicare Advantage compliance experience
• Minimum two years of leadership experience in a compliance-related role
• Strong understanding of CMS regulations and experience with CMS program audits