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Senior Compliance Administrator – Clinical, SNP Model of Care, Care Management, Quality, STARs
Centene Corporation. Support the day-to-day execution of the Medicare Compliance Advisory program in alignment with CMS requirements and applicable federal and state regulations .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Medicare Compliance, regulatory guidance, and risk management, with a strong focus on executing compliance programs and conducting audits. Proficient in developing compliance communications and mentoring stakeholders on regulatory requirements.
Highest-signal resume keywords
Medicare Compliance Program ExecutionRegulatory Research and GuidanceRisk Assessment and MitigationAudit Readiness and MonitoringCertified in Healthcare Compliance (CHC)
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Regulatory AnalysisCompliance Risk AssessmentIssue TrackingCorrective Action PlansPolicy ReviewAudit ExecutionRegulatory ReportingCompliance Training DevelopmentDocumentation SkillsAttention to Detail
Soft Skills
Strong Written CommunicationStrong Verbal CommunicationOrganizational SkillsAnalytical SkillsAbility to Manage Multiple Assignments
Certifications & Qualifications
Certified in Healthcare Compliance (CHC)
Industry Keywords
Medicare RegulationsCMS GuidanceManaged CareMedicare AdvantageDual Eligible ProgramsCompliance AdvisoryRegulated IndustryCross-Functional CollaborationCompliance ProcessesRegulatory Developments
About the role
Key responsibilities & impact- Support the day-to-day execution of the Medicare Compliance Advisory program in alignment with CMS requirements and applicable federal and state regulations
- Provide regulatory guidance, conduct research and analysis, track issues, contribute to audit readiness, and support compliance workplan activities
- Execute the Medicare Compliance Program to prevent, detect, and correct noncompliance and fraud, waste, and abuse (FWA)
- Interpret and translate federal, state, and contractual requirements into actionable compliance guidance
- Develop and coordinate regulatory communications, including inquiry responses, issue summaries, and disclosures
- Support preparation, validation, and submission of regulatory reports, attestations, and filings
- Identify compliance risks, assess business-process exposure, provide risk stratification, and recommend mitigation strategies
- Lead or support issue identification, root cause analysis, and corrective action plans
- Provide subject matter expertise for audits and monitoring activities
- Support audit execution, regulatory reviews, and ongoing audit readiness
- Evaluate remediation plans and validate corrective actions
- Contribute to compliance training and mentor stakeholders on regulatory requirements and best practices
- Review policies, procedures, and business processes for regulatory and contractual alignment
- Lead or contribute to cross-functional initiatives improving compliance processes and operational efficiency
- Monitor regulatory developments and industry trends to identify emerging risks
- Collaborate with compliance, legal, audit, and operational partners
- Perform other duties as assigned and comply with all policies and standards
Requirements
What you’ll need- Bachelor’s degree in a related field (e.g., healthcare administration, public health, policy) or equivalent experience required
- 5+ years Compliance, regulatory, operations, or risk management within a regulated industry
- 4+ years Compliance advisory experience including regulatory research and drafting compliance guidance, assessing risk, issue tracking, auditing/monitoring, and overseeing correction action plans
- 2+ years supporting managed care, Medicare Advantage/Part D, or Dual Eligible (DSNP) programs
- Foundational knowledge of Medicare regulations, including CMS guidance and compliance expectations (e.g., Parts C & D)
- Strong written and verbal communication skills
- Strong analytical, organizational, and documentation skills with attention to detail
- Ability to manage multiple assignments and meet deadlines in a fast-paced environment
- Certified in Healthcare Compliance (CHC) preferred
- Familiarity with CMS audit protocols, program audits, or monitoring activities preferred
- Experience working in a matrixed or cross-functional environment preferred
- Related/relevant licensure (e.g., RN, LPN, Pharmacist, CPhT, Case Management) preferred
Benefits
Comp & perks- Competitive pay
- Health insurance
- 401K
- Stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
- Additional forms of incentives may be included in total compensation
- Equal opportunity employer committed to diversity