Senior Compliance Analyst – Medicare/Medicaid

This is a fully remote position, open to applicants in United States.

📋 Description

• Implement compliance procedures and uphold policy governance to ensure regulatory reporting and operational standards are met.

• Act as a compliance subject matter expert, offering solutions to intricate challenges.

• Improve and enhance supporting documentation.

• Represent the Compliance department in complex contracts and collaborative projects.

• Build and maintain effective partnerships with stakeholders.

• Lead project management for highly sensitive or intricate compliance initiatives.

• Generate clear and precise compliance records and produce executive or governance reports for senior leaders and committees.

• Execute and improve compliance programs, training, conflict of interest protocols, policy governance, and cyclical compliance processes.

• Research and interpret legal statutes, guidance, regulatory issues, and filing requirements.

• Document and escalate any findings appropriately.

• Oversee assigned licensing submissions, filings, renewals, reporting, source documentation, procedures, and tools.

• Perform other assigned duties as needed.

• Adhere to job-specific security responsibilities, as well as legal, regulatory, contractual, and internal policy requirements.

⛳️ Requirements

• A Bachelor’s degree in business, healthcare, or a related field, or a combination of education and/or relevant work experience.

• A high school diploma from an accredited institution or an equivalent GED is required.

• A minimum of 5 years of progressive experience in legal or compliance roles within a healthcare or PBM organization, or another highly regulated sector.

• Familiarity with Medicare, Medicaid, and the Affordable Care Act (ACA).

• Must be eligible to work in the United States without requiring work visa or residency sponsorship.

• Outstanding written and verbal communication abilities.

• Strong critical thinking and problem-solving skills for addressing complex issues.

• In-depth understanding of compliance program principles, practices, standards, industry challenges, and emerging methodologies.

• Capability to convey complex information and influence stakeholders at all organizational levels.

• Advanced organizational and analytical skills; ability to manage multiple projects concurrently.

• Preferred: Experience in PBM or healthcare environments.

• Preferred: Certification as a Compliance and Ethics Professional (CCEP) or in Healthcare Compliance (CHC).

• Preferred: Project Management Professional (PMP) certification.

• Preferred: Experience with Medicare Part D, Medicaid, and/or the Affordable Care Act.

• Preferred: Advanced degree in a related field, such as Juris Doctor.

• Preferred: Experience in maintaining, tracking, renewing, and submitting licensing applications.

🏝️ Benefits

• Benefits, incentives, and additional compensation (details available on the employer’s Benefits Page).

• Equal opportunity and affirmative action employer.

• Reasonable accommodations provided for employees with disabilities.

• Tobacco-free workplace.