Senior Compliance Administrator - Medicare Compliance Advisory

About the role

This individual contributor and subject matter expert role supports the day-to-day execution of the Medicare Compliance Advisory program in line with CMS requirements and federal and state regulations. It works closely with the Sr. Manager, Medicare Compliance Advisory, to interpret CMS requirements accurately, complete assignments on time and document compliance risks, trends and corrective actions consistently.

Key responsibilities

• Translate federal, state and contractual requirements into clear compliance guidance for business stakeholders.
• Develop and coordinate regulatory communications, including responses to inquiries, issue summaries and disclosures, and liaise with internal stakeholders and external regulators.
• Support the preparation, validation and submission of regulatory reports, attestations and filings.
• Identify compliance risks, evaluate business processes, provide risk stratification and recommend mitigation strategies.
• Lead or support root cause analysis and corrective action plans, and validate remediation plans.
• Provide subject matter expertise to audit and monitoring activities, including audit scope development, testing strategies and audit readiness.
• Contribute to compliance training and review policies, procedures and processes for regulatory alignment.
• Monitor regulatory developments and collaborate with compliance, legal, audit and operational partners.

Required profile

• Bachelor's degree in a related field (healthcare administration, public health, policy) or equivalent experience; Master's degree or Juris Doctor preferred.
• 5+ years in compliance, regulatory, operations or risk management within a regulated industry such as healthcare, managed care, insurance or public sector.
• 4+ years of compliance advisory experience, including regulatory research, drafting guidance, risk assessment, issue tracking and corrective action plans.
• 2+ years supporting managed care, Medicare Advantage/Part D or Dual Eligible (DSNP) programs.
• Foundational knowledge of Medicare regulations, including CMS guidance and Parts C & D.
• Certified in Healthcare Compliance (CHC) preferred; familiarity with CMS audit protocols preferred; matrixed environment experience preferred.

Required skills

• Strong written and verbal communication, analytical and documentation skills with attention to detail.
• Ability to manage multiple assignments and meet deadlines in a fast-paced environment.
• Related licensure (RN, LPN, Pharmacist, CPhT, Case Management) preferred.

What we offer

• Pay range of $87,700 to $157,800 per year, adjusted for skills, experience and other factors.
• Health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays.
• Flexible work arrangements, including remote, hybrid, field or office schedules.