Senior Manager – Medicare Compliance

Job Description:

• Lead compliance program administration, regulatory implementation, and technology enablement across Medicare Advantage, Part D, and Medigap distribution channels
• Leverage technology, advanced analytics, workflow automation, and artificial intelligence to strengthen compliance oversight and operational efficiency
• Support implementation, administration, optimization, and continuous improvement of compliance technology platforms, regulatory libraries, QA solutions, and workflow management tools
• Translate regulatory mandates into technical business requirements, system specifications, sales scripts, and automated compliance rules inside CRMs and dialing systems
• Direct compliance investigations, corrective action plans, departmental communications, and regulatory reporting across captive and independent sales channels
• Develop, maintain, and analyze compliance dashboards, KPIs, and metrics
• Conduct root-cause analysis on compliance deviations, agent misrepresentation allegations, and customer grievances
• Coordinate and monitor implementation of federal and state regulatory changes across sales, marketing, and operations
• Develop implementation documentation, training materials, communication plans, and user adoption strategies
• Serve as primary compliance liaison between Business Operations, Sales Leadership, Quality Assurance, and Engineering/Tech teams
• Facilitate workgroups, governance meetings, and stakeholder sessions; manage project milestones, risks, dependencies, and business outcomes
• Analyze 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 equivalent combination of education and experience)
• 5+ years of progressive experience in healthcare compliance, Medicare Advantage (Part C & D), regulatory operations, business systems, or technology implementation
• Strong knowledge of CMS Medicare Marketing Guidelines (MMG), TPMO regulations, telesales compliance, and health plan partner standards
• Demonstrated experience gathering business/technical requirements, supporting software/system deployments, and developing data dashboards and analytics

Benefits:

• Competitive salary + generous quarterly bonus
• Unlimited PTO
• Industry-leading medical, dental, and vision plans
• Generous parental leave
• 401(k) company match plan – fully vested day 1
• Award-winning culture & unprecedented team spirit
• Paid charity and volunteer days
• Career growth – we enjoy promoting from within!