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.

Applicants for this role will have the flexibility to work remotely anywhere in the Continental United States.

Position Purpose:

Serves as a strategic compliance leader and subject matter expert responsible for overseeing and advancing the Medicare Compliance Program in alignment with CMS requirements and applicable federal and state regulations. Provides trusted advisory support to business and compliance leadership by interpreting regulatory guidance, assessing risk, and translating complex requirements into practical, compliant business solutions. The position leads compliance strategy execution, regulatory interactions, risk mitigation activities, and continuous improvement initiatives while managing a team of compliance professionals and fostering a strong, risk‑based compliance culture across Medicare programs.

• Lead and execute the Medicare Compliance Program in alignment with CMS and applicable federal and state regulations, ensuring prevention, detection, and correction of non-compliance and FWA.
• Serve as a compliance advisor and subject matter expert for Medicare programs, interpreting CMS guidance and translating regulatory requirements into actionable business direction.
• Develop, implement, and oversee compliance strategies, policies, and processes that promote ethical conduct, regulatory adherence, and sustainable compliance across Medicare business.
• Identify regulatory risks, analyze trends, escalate issues, oversee corrective action plans (CAPs), and contribute to risk assessments, auditing and monitoring activities as necessary.
• Manage and coordinate regulatory responses and interactions, including audits, data requests, inquiries, and routine communications, ensuring timely, accurate, and consistent submissions.
• Maintain in depth knowledge of Medicare regulations, contracts, and CMS operational guidance, monitoring regulatory changes and advising leadership on compliance impact and implementation needs.
• Partner with cross functional stakeholders to embed compliance requirements into business processes which support compliant execution of Medicare programs.
• Support compliance training and education initiatives for employees, leadership, and FDRs, ensuring awareness of Medicare regulatory program requirements, standards of conduct, and reporting obligations.
• Analyze and report Medicare compliance risks, issues, and trends to senior leadership and compliance committees, supporting informed decision making and regulatory transparency.
• Lead or support process improvement initiatives to strengthen compliance controls, improve audit readiness, and enhance the effectiveness of Medicare compliance operations.
• Build and maintain productive relationships with internal and external stakeholders, including regulators and compliance peers, to influence compliant outcomes in a complex, highly regulated environment.
• Lead a team of compliance professionals building a strong, risk-based compliance culture that supports regulatory adherence, operational effectiveness, and ethical decision-making.
• Performs other duties as assigned.
• Comply with all policies and standards.

Education/Experience:

• Bachelor's Degree Healthcare Administration Compliance or equivalent experience required. Master's Degree or Juris Doctor preferred.
• 5+ years Compliance experience including reading and interpreting regulatory guidance and assessing risk, overseeing the development and implementation of compliance strategies, administration of correction action plans, and managing regulatory relationships required.
• 2+ years Managed care required.
• Management experience including responsibilities for hiring, training, assigning work and managing staff performance required.

Pay Range: $107,700.00 - $199,300.00 per year

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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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