Senior Compliance Administrator, Medicare Claims – Payment Integrity

Centene Corporation

Senior Compliance Administrator managing CMS-aligned Medicare Compliance Advisory program for Centene. Provide regulatory guidance and support compliance workplan activities across various Medicare programs.

Posted 6/17/2026full-timeRemote • Florida, Illinois, Montana • 🇺🇸 United StatesSenior💰 $87,700 - $157,800 per yearWebsite

About the role

Key responsibilities & impact

Serves as an individual contributor and subject matter expert responsible for supporting the day-to-day execution of the Medicare Compliance Advisory program in alignment with CMS requirements and applicable federal and state regulations
Provides trusted advisory support to business and compliance leadership by providing regulatory guidance, conducting research and analysis, tracking issues, contributing to audit readiness and supporting compliance workplan activities
Partners closely with the Sr. Manager, Medicare Compliance Advisory
Execute the Medicare Compliance Program in alignment with CMS and applicable federal and state regulations, ensuring prevention, detection, and correction of noncompliance and FWA
Execute assignments, ensuring timely, accurate, and well-documented completion of deliverables
Serve as a compliance advisor and subject matter resource for Medicare programs by interpreting CMS regulations and guidance and translating requirements into clear, actionable business input; as well as advising leadership on compliance impact and implementation needs
Support intake, tracking, and resolution of compliance issues, including documenting findings, assessing risk, and recommending corrective actions
Contribute to monitoring and oversight activities by identifying regulatory risks and trends and supporting resolution of identified issues
Prepare draft responses and supporting materials for regulatory inquiries, audits, data requests, and internal compliance reviews
Maintain accurate and complete documentation of compliance activities, including issue logs, regulatory references, self-disclosures and supporting evidence
Collaborate with cross-functional business partners to clarify regulatory requirements and support the implementation of compliant processes
Escalate compliance risks, gaps, or delays in a timely manner to support effective risk management and decision-making
Contribute to audit readiness by supporting documentation, process validation, and issue resolution activities
Identify process improvement opportunities and support initiatives to enhance compliance controls, standardization, and operational efficiency
Support compliance training and education initiatives, ensuring awareness of Medicare regulatory program requirements, standards of conduct, and reporting obligations.

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 (e.g., healthcare, managed care, insurance, or public sector)
Demonstrated experience interpreting and applying complex regulatory frameworks and compliance program requirements within a regulated environment into clear, actionable guidance for business stakeholders required
Experience leading cross-functional initiatives or large-scale compliance efforts, required
Experience conducting risk assessments, analyzing data, and applying structured problem-solving approaches to identify compliance risks and recommend mitigation strategies required
Experience effectively communicating with and managing relationships across stakeholders, including presenting complex compliance concepts to diverse audiences required
Demonstrated experience influencing cross-functional partners and driving outcomes in a matrixed environment without direct authority required
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)

Benefits

Comp & perks

competitive pay
health insurance
401K and stock purchase plans
tuition reimbursement
paid time off plus holidays
flexible approach to work with remote, hybrid, field or office work schedules

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

regulatory guidancerisk assessmentdata analysiscompliance program requirementsprocess validationissue resolutioncompliance trainingaudit readinessproblem-solvingdocumentation

Soft Skills

communicationrelationship managementinfluencingcollaborationleadershipadvisory supportcross-functional initiative leadershippresentation skillsstakeholder engagementdecision-making