Senior Manager, Medicare Sales Compliance Advisory
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Job Description
Strategic compliance leader overseeing and advancing the Medicare Sales Compliance Program at Centene. Providing advisory support and managing compliance culture across various Medicare programs.
Responsibilities:
- Serves as a strategic compliance leader and subject matter expert responsible for overseeing and advancing the Medicare Sales Compliance Program in alignment with CMS requirements and applicable federal and state regulations
- Provides trusted advisory support to business and compliance leadership by interpreting regulatory guidance, assessing risk, and translating complex requirements into practical, compliant business solutions
- Leads compliance strategy execution, regulatory interactions, risk mitigation activities, and continuous improvement initiatives while managing a team of compliance professionals and fostering a strong, risk‑based compliance culture across Medicare programs
- Develops, implements, and oversees compliance strategies, policies, and processes that promote ethical conduct, regulatory adherence, and sustainable compliance across Medicare business
- Identifies regulatory risks, analyzes trends, escalates issues, oversees corrective action plans (CAPs), and contributes to risk assessments, auditing and monitoring activities as necessary
- Maintains in depth knowledge of Medicare regulations, contracts, and CMS operational guidance, monitoring regulatory changes and advising leadership on compliance impact and implementation needs
- Partners with cross functional stakeholders to embed compliance requirements into business processes which support compliant execution of Medicare programs
- Supports compliance training and education initiatives for employees, leadership, and FDRs, ensuring awareness of Medicare regulatory program requirements, standards of conduct, and reporting obligations
- Analyzes and reports Medicare compliance risks, issues, and trends to senior leadership and compliance committees, supporting informed decision making and regulatory transparency
Requirements:
- Bachelor’s degree in healthcare administration, compliance or related experience or equivalent experience required
- Master's Degree or Juris Doctor (JD) preferred
- 5+ years Compliance experience including reading and interpreting regulatory guidance and assessing risk, overseeing the development and implementation of compliance strategies, administration of correction action plans, and managing regulatory relationships required
- 2+ years Managed care required
- Management experience including responsibilities for hiring, training, assigning work and managing staff performance required
Benefits:
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
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