Compliance Associate – Medicare/Medicaid

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

📋 Description

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

• Document notifications, coordinate communication internally and externally, and monitor investigations to ensure timely resolutions.

• Detect compliance trends through both internal and external reporting mechanisms.

• Support the development of compliance guidelines and tools.

• Assist in managing call center activities.

• Organize, record, maintain, and supervise compliance documentation, reports, and analyses.

• Aid in internal and external audits as well as designated compliance issues.

• Review advertisements, social media content, and websites created by agents.

• Provide compliance advice to both internal and external stakeholders.

• Assist with the submission of marketing materials for approval from carriers and regulatory bodies.

• Support the Compliance Officer in administering and enhancing the Compliance Program.

• Help respond to alleged violations and report them to enforcement agencies when necessary or required.

• Monitor relevant statutes and regulations, distributing updates throughout the Company and to downstream agents.

• Assist in the creation and oversight of compliance training for employees and downstream agents.

• Oversee and coordinate compliance activities across various business units, tracking and reporting compliance metrics.

• Identify compliance vulnerabilities and risks, assisting with the development of corrective action plans.

• Participate in relevant internal and external committees and manage special projects.

• Execute other duties as assigned by management.

⛳️ Requirements

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

• A minimum of 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 evaluation of outcomes, quality assurance, and satisfaction measurement and interpretation.

• Understanding of supervisory techniques to facilitate instruction, motivation, and training.

• Proficient in computer applications, including Microsoft Word, Excel, PowerPoint, Adobe Acrobat, and MS Outlook.

• Strong oral and written communication skills.

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

• Excellent verbal and written proficiency in English required; bilingual in Spanish and English preferred.

• Ability to uphold company policies, including those related to confidentiality and safety.

• Capability to work independently, exercise sound judgment, and make informed decisions.

• Strong organizational skills and attention to detail while managing multiple urgent requests.

🏝️ Benefits

• Comprehensive health and wellness programs.

• Opportunities for professional development and career advancement.

• Flexible work arrangements to support work-life balance.

• Competitive salary and performance-based incentives.

• Supportive team environment and company culture.