Senior Manager – Medicare Compliance

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

📋 Description

• Oversee the administration of compliance programs, ensure regulatory implementation, and enable technology across Medicare Advantage, Part D, and Medigap distribution channels.

• Utilize technology, advanced analytics, workflow automation, and artificial intelligence to enhance compliance oversight and improve operational efficiency.

• Assist in the implementation, administration, optimization, and ongoing enhancement of compliance technology platforms, regulatory libraries, quality assurance solutions, and workflow management tools.

• Convert regulatory mandates into technical business requirements, system specifications, sales scripts, and automated compliance rules within CRMs and dialing systems.

• Lead compliance investigations, develop corrective action plans, facilitate departmental communications, and manage regulatory reporting across both captive and independent sales channels.

• Create, maintain, and analyze compliance dashboards, key performance indicators (KPIs), and metrics.

• Perform root-cause analysis on compliance deviations, allegations of agent misrepresentation, and customer complaints.

• Coordinate and oversee the implementation of federal and state regulatory changes across sales, marketing, and operations.

• Develop implementation documentation, training resources, communication strategies, and user adoption plans.

• Act as the primary compliance liaison among Business Operations, Sales Leadership, Quality Assurance, and Engineering/Tech teams.

• Facilitate workgroups, governance meetings, and stakeholder sessions; manage project milestones, risks, dependencies, and business results.

• Evaluate operational and sales workflows to standardize, optimize, and streamline compliance checkpoints.

⛳️ Requirements

• Bachelor's Degree in Healthcare Administration, Business Administration, Information Systems, Compliance, Health Informatics, Project Management, or a related field (or an equivalent combination of education and experience).

• Over 5 years of progressive experience in healthcare compliance, Medicare Advantage (Part C & D), regulatory operations, business systems, or technology implementation.

• In-depth knowledge of CMS Medicare Marketing Guidelines (MMG), TPMO regulations, telesales compliance, and standards of health plan partners.

• Proven experience in gathering business/technical requirements, supporting software/system deployments, and creating data dashboards and analytics.

🏝️ Benefits

• Competitive salary plus a generous quarterly bonus.

• Unlimited paid time off (PTO).

• Industry-leading medical, dental, and vision insurance plans.

• Generous parental leave policy.

• 401(k) company matching plan with full vesting from day one.

• Award-winning company culture and exceptional team spirit.

• Paid days off for charity work and volunteering.

• Opportunities for career advancement – we prioritize promoting from within!