Medicare Compliance Manager
: Job Details :

We are partnered with the fastest-growing health insurance marketplace, leveraging advanced technology and personalized service to simplify the enrollment process for ACA and Medicare enrollees. Backed by the industry's top carriers and investment partners, their passionate and innovative teams are dedicated to transforming the healthcare experience.

As the Medicare Compliance Manager, you will be responsible for ensuring that our organization complies with all Medicare Advantage regulations and guidelines. Reporting directly to the Chief Compliance Officer, you will work closely with our client's compliance team to develop and implement policies and procedures that meet regulatory requirements. Additionally, you will be responsible for conducting audits and investigations to identify areas of non-compliance and develop corrective action plans.

REWARDS:

• Competitive base salary of $100K
• Comprehensive Medical, Dental, and Vision coverage
• PTO and holiday pay
• 401(k) matching
• Advancement Opportunities

REQUIREMENTS:

• Bachelor's degree in healthcare administration, business administration, or related field.
• Minimum of 5 years experience in healthcare compliance, with a focus on Medicare Advantage.
• Minimum of 5 years of experience with a strong understanding of Medicare Advantage regulations and compliance.
• Excellent analytical and problem-solving skills.
• Strong communication and interpersonal skills.
• Experience working with and leading teams.

RESPONSIBILITIES:

• Create, maintain, and enhance the compliance program for Medicare Advantage, including the development of policies, procedures, and controls.
• Develop a compliance roadmap that aligns with regulatory requirements and business objectives.
• Stay up to date with changes in Medicare Advantage regulations or industry standards.
• Establish a robust auditing and monitoring program to assess compliance with regulatory requirements.
• Develop and deliver compliance training programs for employees and stakeholders.
• Prepare and submit the required compliance reports to regulatory authorities as necessary.
• Maintain comprehensive records and documentation of compliance activities.
• Collaborate with cross-functional teams, including legal, operations, and quality assurance, to ensure alignment on compliance initiatives.
• Serve as subject matter expert on Medicare Advantage compliance.

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Emerge is committed to being an equal-opportunity employer. We prohibit discrimination and harassment based on race, color, religion, age, sex, national origin, disability, genetics, veteran status, sexual orientation, gender identity or expression, or any other protected characteristic. In compliance with the Job Application Fairness Act, we ensure a fair and equitable recruitment process and provide necessary and reasonable accommodations. We value diversity and encourage individuals from all backgrounds and experiences to apply.