Senior Strategic Advisor, Healthcare

E-Verify Program

. Serve as a senior subject matter expert on Medicare Advantage payment, reimbursement, and claims-related CMS policy .

Posted 4/29/2026full-timeNorth Carolina • 🇺🇸 United StatesSenior💰 $89,174 - $142,679 per yearWebsite

About the role

Key responsibilities & impact

Serve as a senior subject matter expert on Medicare Advantage payment, reimbursement, and claims-related CMS policy
Interpret and evaluate CMS guidance, health plan reimbursement direction, delegation requirements, and contractual payment terms
Support periodic reviews of Medicare payment and reimbursement application across claims adjudication and provider payment processes
Collaborate with Compliance and operational teams in preparation for CMS audits, health plan delegation audits, and internal reviews

Requirements

What you’ll need

Bachelor’s degree in Healthcare Administration, Business, Finance, or related field
5 years of relevant experience
Medicare Advantage experience with exposure to reimbursement, claims payment, or payment policy
Strong working knowledge of CMS Medicare Advantage payment regulations
Experience operating in a matrixed or shared-services environment
Understanding of claims adjudication logic, provider payment methodologies, and claims platforms (e.g., FACETS)

Benefits

Comp & perks

Annual Incentive Bonus*
401(k) with employer match
Paid Time Off (PTO)
Competitive health benefits and wellness programs

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Medicare Advantagereimbursementclaims paymentpayment policyclaims adjudicationprovider payment methodologiesCMS Medicare Advantage payment regulationsclaims adjudication logic

Soft Skills

collaborationinterpretationevaluation