Hershey, Pennsylvania
Morristown, New Jersey
Wailuku, Hawaii
New York
Chicago, Illinois
North Carolina
Morristown, New Jersey
Kailua-Kona, Hawaii
Aiea, Hawaii
Posted: 20-Mar-25
Location: Los Angeles, California
Categories:
Internal Number: 146755098
We are seeking a highly skilled and independent professional to play a key role in the development, implementation, and maintenance of our organization’s compliance program. This position will have a significant and wide-reaching impact on the organization's compliance status and the viability of new products. The ideal candidate will bring expert-level knowledge of CMS and DMHC legal and regulatory requirements, as well as industry best practices, specifically in relation to Medicare Advantage health plan operations within an integrated system.
You will:
Salary Range: $83,800-179,400/annually• Lead and execute day-to-day tasks related to the department’s compliance program, ensuring adherence to regulatory standards.
• Develop and implement compliance procedures tailored to the organization’s structure, experience, and product offerings.
• Collaborate across multiple levels of the organization to drive participation, efficiency, and compliance within the program.
• Ensure the effective communication and oversight of compliance-related activities across a wide scope of business partners and operational units.
• Maintain a deep understanding of regulatory requirements and best practices related to Medicare Advantage health plan operations.
• Act as a trusted advisor and partner, providing expertise and guidance to ensure compliance program success.
We’re seeking a detail-oriented, self-directed individual with:
• Bachelor’s Degree or five (5) Medicare Compliance experience at a health plan in lieu of degree.
• Minimum of three (3) years previous experience in compliance oversight role.
• Experience with a Medicare Advantage health plan with integrated system strongly preferred.
• Strong working knowledge of CMS regulations, audits, expectations, and best practices.
• Experience interacting with regulatory agencies and/or auditors.
• Strong technical, organizational, and analytical abilities.
• Excellent communication skills, both written and oral, with the ability to engage effectively diverse audiences.
• Adaptable and able to thrive in dynamic environment, responding effectively to change.
• Comfortable working in a fast-paced, startup setting where processes are still being defined.
