Medicare Sales Compliance Specialist

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

Position Purpose: Supports the Medicare Sales Compliance team in the management of regulatory requirements associated with the Medicare sales compliance and third-party marketing materials. Consults on sales compliance topics, audits of Medicare sales activities and participates in the oversight, analysis, review, and approval of all third-party beneficiary-facing Medicare materials.

• Performs comprehensive, complex regulatory analyses, including the review, summarization and dissemination of key regulatory updates and changes.  
• Provides regulatory support and advice to business owners as new regulations emerge. Partners with business areas to help ensure processes and policies are implemented to comply with CMS regulatory and contractual requirements. 
• Preforms routine audits of various sales activities; including, but not limited to, sales events, broker websites, telephonic recordings, secret shopping, etc. 
• Reviews carrier and/or third-party marketing materials for adherence to regulatory and state requirements.  
• Monitors and reports to management on the status of assigned projects, anticipating and identifying issues that could inhibit achieving the project goals and objectives, and implementing corrective actions and mitigation strategies. 
• Coordinates the filing of regulatory forms, reports, marketing materials, etc. May also assist other departments in understanding and complying with regulatory requirements and data entry of submission and preparation of regulatory forms, reports, and data.   
• Performs special projects as assigned. 

Education/Experience:

• Bachelor’s degree in Health Administration, related field, or equivalent experience required.
• 3+ years of experience in Managed Care/Health Insurance/Public Health/Health Care Administration/ Medicare Part D or related field required.
• Some experience in State or Federal managed care compliance required.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.  Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act