Senior Compliance Administrator - Network, Provider, Product
Core
Individual contributor and subject matter expert supporting the day-to-day execution of the Medicare Compliance Advisory program in alignment with CMS requirements and federal/state regulations.
Role type
Senior Compliance Administrator (Medicare/Healthcare)
Builds
Regulatory guidance, compliance workplans, audit readiness, and corrective action plans for Medicare Advantage/Part D programs.
Domain
Healthcare / Medicare Compliance
Required skills
Medicare regulations knowledge, regulatory research, risk assessment, audit support, policy review, corrective action planning, stakeholder liaison
Preferred skills
Master's Degree or Juris Doctor, CHC certification, CMS audit protocol familiarity, managed care program experience
Technologies
CMS systems, regulatory reporting tools
Responsibilities
Execute Medicare Compliance Program, interpret federal/state requirements, develop regulatory communications, support audit execution, identify compliance risks, lead root cause analysis, contribute to compliance training, monitor regulatory developments
Seniority
Senior, hands-on IC
