Medicare Regulatory Analyst

Health Care Service Corporation

Analyst coordinating receipt and submission of Medicare materials for HCSC. Supporting compliance documentation and cross-departmental initiatives related to Medicare Advantage regulations.

Posted 5/28/2026full-timeRemote • Illinois, Montana, New Mexico, Oklahoma, Tennessee • 🇺🇸 United StatesJuniorMid-Level💰 $41,700 - $92,800 per yearWebsite

About the role

Key responsibilities & impact

responsible for receipt and coordination of CMS MA-PD and PDP escalated complaints
submission of member and marketing materials to CMS for HCSC’s Medicare Advantage and Prescription Drug Plans
applying CMS regulations pertaining to Medicare Advantage and Prescription Drug Plans to the review of member and marketing materials prior to submission to CMS
providing assistance and guidance regarding Medicare Advantage and Prescription Drug Plan regulations to HISC staff
working with other areas of the organization on the development, testing and implementation of organization, process and system changes to ensure the requirements of the Medicare Advantage and Prescription Drug program are met
assisting MCO in coordination of the contract with CMS enterprise-wide

Requirements

What you’ll need

Bachelor’s degree in business OR 2 years’ experience with health insurance
1 year of experience with health insurance benefits and/or operations
Knowledge of Medicare advantage product
Verbal and written communication skills
Ability to present Medicare trends and findings in meetings with management
Ability to organize multiple tasks and responsibilities
Ability to analyze data reports
Experience developing and running queries in a database
PC proficiency to include Microsoft Word, Excel, PowerPoint, and Lotus Notes

Benefits

Comp & perks

health and wellness benefits
401(k) savings plan
pension plan
paid time off
paid parental leave
disability insurance
supplemental life insurance
employee assistance program
paid holidays
tuition reimbursement
plus other incentives

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

health insurance operationsMedicare Advantage product knowledgedata analysisdatabase queries

Soft Skills

verbal communicationwritten communicationpresentation skillsorganizational skills

Certifications

Bachelor's degree in business