Compliance Associate – Medicare/Medicaid

This is a fully remote position, open to applicants in Illinois, +4 more states.

📋 Description

• Oversee investigations into carrier compliance regarding alleged breaches of rules, regulations, policies, procedures, and conduct standards.

• Document notifications, manage both internal and external communications, and monitor investigations to ensure prompt responses.

• Analyze compliance trends through various internal and external reports.

• Support the creation of compliance guidelines and tools.

• Assist in supervising call center operations.

• Organize, document, maintain, and oversee compliance records, reports, and analytical data.

• Aid in conducting internal and external audits as well as managing specified compliance issues.

• Evaluate advertisements, social media, and websites created by agents.

• Offer compliance advice to both internal and external stakeholders.

• Assist in the submission process of marketing materials for carrier and regulatory approval.

• Collaborate with the Compliance Officer to manage and enhance the Compliance Program.

• Help respond to alleged violations and report them to enforcement agencies as necessary or mandated.

• Stay updated on statutes and regulations, communicating changes throughout the Company and to downstream agents.

• Support the development and management of compliance training programs for employees and downstream agents.

• Oversee and coordinate compliance activities across business units while tracking and reporting on compliance metrics.

• Identify compliance weaknesses and risks, assisting in the formulation of corrective action plans.

• Participate in relevant internal and external committees and undertake special projects as assigned.

• Execute additional tasks as directed by management.

⛳️ Requirements

• A Bachelor’s degree in business or a related discipline.

• At least one (1) year of experience in compliance.

• Experience in the insurance industry or a related field such as financial services or marketing.

• Carrier certification with MA/PDP.

• Familiarity with federal, state, and local laws, as well as industry regulations.

• Understanding of the insurance services sector.

• Knowledge of general industry practices, procedures, and terminology.

• Proficiency in systems management.

• Experience in program and project management, including outcome assessment, quality assurance, and satisfaction measurement and interpretation.

• Understanding of supervisory techniques for effective instruction, motivation, and training.

• Strong computer skills, including proficiency in Microsoft Word, Excel, PowerPoint, Adobe Acrobat, and MS Outlook.

• Effective oral and written communication skills.

• Ability to read, write, and communicate proficiently in English.

• Strong verbal and written English skills required; bilingual proficiency in Spanish and English is preferred.

• Capability to uphold company policies, including confidentiality and safety protocols.

• Ability to work autonomously, demonstrate independent judgment, and make and implement decisions.

• Skill in maintaining organization and attention to detail while managing multiple urgent requests.

🏝️ Benefits

• Comprehensive health benefits.

• Flexible working hours.

• Opportunities for professional development and career advancement.

• Supportive work environment fostering teamwork and collaboration.