Senior Compliance Administrator - Medicare Enrollment, Billing, Finance, DIR

About the role

This individual contributor and subject matter expert supports the day-to-day execution of the Medicare Compliance Advisory program in line with CMS requirements and federal and state regulations. The role provides regulatory guidance, research and analysis, tracks issues, contributes to audit readiness and works closely with the Sr. Manager, Medicare Compliance Advisory.

Key responsibilities

• Execute the Medicare Compliance Program and interpret federal, state and contractual requirements into actionable 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, stratify risk and recommend mitigation strategies.
• Lead or support issue identification, root cause analysis and corrective action plans, and validate remediation plans.
• Provide subject matter expertise to audit and monitoring activities, including audit scope, testing strategies and audit readiness.
• Contribute to compliance training, review policies and procedures, and lead cross-functional initiatives.
• Monitor regulatory developments and industry trends, 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, auditing/monitoring 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.

Required skills

• Strong written and verbal communication, analytical, organizational and documentation skills.
• Ability to manage multiple assignments and meet deadlines in a fast-paced environment.
• Experience in a matrixed or cross-functional environment 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.