Senior Compliance Administrator – Grievances, CTMs, Call Center, FDR, Off-Shore, Privacy

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 .

Posted 10/26/2026full-timeRemote • United StatesSenior💰 $87,700 - $157,800 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Medicare Compliance, regulatory guidance, and risk management, with a strong focus on audit readiness and corrective action planning. Proficient in translating complex regulatory requirements into actionable compliance strategies while fostering collaboration across cross-functional teams.

Highest-signal resume keywords

Medicare ComplianceRegulatory GuidanceRisk ManagementCompliance Advisory ExperienceCertified in Healthcare Compliance (CHC)

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Regulatory ResearchIssue TrackingAuditingMonitoringCorrective Action PlansCompliance TrainingPolicy ReviewRisk StratificationRegulatory ReportingCompliance Documentation

Soft Skills

Strong Written CommunicationStrong Verbal CommunicationAnalytical SkillsOrganizational SkillsAttention to Detail

Certifications & Qualifications

Certified in Healthcare Compliance (CHC)

Industry Keywords

Medicare AdvantageDual Eligible ProgramsCMS GuidanceFederal RegulationsState RegulationsCompliance ProcessesAudit ProtocolsRegulated IndustryHealthcare AdministrationPublic Health

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 FWA
Interpret and translate federal, state, and contractual requirements into actionable compliance guidance
Develop and coordinate regulatory communications, including responses to inquiries, issue summaries, and disclosures
Support preparation, validation, and submission of regulatory reports, attestations, and filings
Identify compliance risks, evaluate business processes, assess exposure, provide risk stratification, and recommend mitigation strategies
Lead or support issue identification, root cause analysis, and corrective action plans
Provide subject matter expertise to audit 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, policies, and best practices
Review policies, procedures, and business processes for regulatory and contractual alignment
Lead or contribute to cross-functional initiatives to enhance 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
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 corrective action plans
2+ years experience 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
Master's Degree or Juris Doctor preferred
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

Benefits

Comp & perks

Competitive pay
Health insurance
401K plan
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, subject to eligibility