Back to positions

Compliance Manager – Medicare / Health Insurance

Remote role Full-time Open position

Position: Compliance Manager – Medicare / Health Insurance Location: Remote – United States Compensation: Salary – Starting at $80K + Bonus Compliance Manager – Medicare / Health Insurance

About the Role

We are seeking a detail-oriented and knowledgeable Compliance Manager to ensure full regulatory compliance across our marketing and sales operations for Medicare Advantage, Part D, MedSupp, ACA, and ancillary products. This role supports the timely, accurate delivery of marketing communications and oversees adherence to CMS guidelines, CFR requirements, and all applicable federal and state laws. The ideal candidate has strong regulatory experience, exceptional organizational skills, and a proactive approach to continuous improvement. This role reports to the Chief Compliance Officer.

Key Responsibilities

Regulatory Oversight and Compliance

  • Maintain deep understanding of CMS guidelines and other regulatory requirements impacting the sales and marketing of Medicare and related health insurance products.
  • Prepare, review, and file required marketing materials and documents in HPMS within mandated timelines.
  • Ensure continual development, implementation, and management of the organization’s compliance program, ensuring adherence to relevant laws, regulations, and contract standards.
  • Provide guidance and actionable summaries of CMS updates and Code of Federal Regulations (CFR) changes.

Auditing, Monitoring, and Process Improvement

  • Manages / conduct audits of marketing materials and internal processes to identify and mitigate compliance risks.
  • Manages and perform ongoing compliance monitoring to ensure accuracy, timeliness, and adherence to procedures.
  • Develop and refine Standard Operating Procedures (SOPs) and analyze key performance indicators to measure compliance effectiveness.
  • Lead process improvement initiatives to enhance compliance outcomes and operational efficiency.

Collaboration and Training

  • Partner with Marketing, Legal, and Operations teams to ensure regulatory compliance throughout campaign development and execution.
  • Provide training, tools, and clear regulatory updates to internal teams to foster a culture of compliance and accountability.
  • Partner with Training and Sales leaders to ensure compliance education is embedded into onboarding, ongoing training, and remediation workflows.

Qualifications

Required

  • Strong working knowledge of and experience with CMS marketing regulations, HPMS filing systems, and federal/state health plan compliance requirements.
  • 5-7+ Prior experience in Medicare compliance, marketing, auditing, investigations, or regulatory oversight. *Unfortunately, candidates without a proven track record in Medicare Advantage will not be considered.
  • Demonstrated experience managing others in a compliance, quality, or regulated environment.
  • Excellent written and verbal communication skills with strong documentation discipline.
  • High attention to detail, organizational skills, and ability to manage multiple priorities.
  • Bachelor’s degree in Business, Law, Healthcare Administration, or related field (Master’s preferred).

Preferred

  • Previous people-management or team-lead experience.
  • Experience working with HPMS and Medicare marketing material submissions.
  • Experience partnering cross-functionally with Sales, Training, and Operations teams.
  • Familiarity with call monitoring, agent compliance scorecards, or quality programs.
  • Certified in Healthcare Compliance (CHC) or related credential preferred.

Why Join Us

  • Opportunity to shape and scale a rapidly growing technical organization
  • High visibility role partnering directly with senior leadership
  • Collaborative and mission-driven culture
  • Ability to influence long-term strategy and operational direction
  • Meaningful ownership across systems, processes, and cross-functional outcomes

Telecommuting Requirements

  • Ability to keep all company-sensitive data secure.
  • Required to have a dedicated work area established that is separated from other living areas and provides information privately without disruption.
  • Must live in a location that can receive a high-speed internet connection or leverage an existing high-speed internet service.

What we offer!

  • Paid Time Off.
  • Paid Company Holidays.
  • Medical, Dental, Vision, Life Insurance, HSA, FSA, and more.
  • 401 (K) savings plan with company matching up to 3%.
  • Work-Life Resources for you and your family.
  • Discounts with Hotels, Rental Cars, Entertainment, Attractions, & More!
  • Maternity/Paternity/Adoption paid leave.
  • Referral program.
  • Company-supplied computer equipment.

Recruitment Process We are committed to creating a fair and transparent hiring process. As part of this process, we conduct reference checks and past employment verifications for all shortlisted candidates. This helps us ensure the accuracy of information provided and gain valuable insights into your qualifications and work ethic. We are an E-Verify Employer: To comply with federal law, we utilize the E-Verify system to verify the employment eligibility of all new hires. For more information about E-Verify, please visit the U.S. Citizenship and Immigration Services (USCIS) website: E-Verify USCIS website: www.uscis.gov/e-verify. EEOC Statement: MyPlanAdvocate is an equal-opportunity employer. MyPlanAdvocate prohibits discrimination and harassment of any type and affords equal employment opportunities to employees and applicants without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law. MyPlanAdvocate conforms to the spirit as well as to the letter of all applicable laws and regulations. The pay range for this role is: 80,000 - 100,000 USD per year(Remote (United States)) Apply tot his job Apply To this Job

Further positions

Medical Claims Auditor (Remote - Texas)

Remote role Full-time

Healthcare Compliance Analyst HYBRID - ONSITE IN KALAMAZOO, MI/REMOTE

Remote role Full-time

Senior Analyst or Consultant, Revenue Cycle, Healthcare Consulting

Remote role Full-time

AVP, Compliance (Remote in Washington State)

Remote role Full-time

State Health - Senior Consultant

Remote role Full-time

Claims Technician - Claims Data Administration

Remote role Full-time

Healthcare Operations Manager - Contract Hub

Remote role Full-time

[Remote] (Senior / Lead) Healthcare Informatics Analyst

Remote role Full-time

Clinical Informatics Specialist - Chart Preparation

Remote role Full-time

Cerner Women’s Health Informatics Specialist

Remote role Full-time

2024 Fall Remote Higher Elementary Math Teacher | Think Academy US | $15 – $30 | Remote (US)

Remote role Full-time

Business Analyst - Level 2 (Remote)

Remote role Full-time

Starbucks Barista

Remote role Full-time

Platform Engineer/Performance Tester

Remote role Full-time

Experienced Customer Chat Support Specialist – Remote Work Opportunity with Comprehensive Training and Growth Prospects

Remote role Full-time

Require Patient Services Associate - Perlmutter Cancer Center - Per Diem (At least 2 shifts per week) in Brooklyn, NY

Remote role Full-time

Join Today: (Part Time / Work From Home) American Express Virtual

Remote role Full-time

Fraud Mitigation Solutions - Level 3 Fraud Analyst - CEC

Remote role Full-time

Principal Payroll Accountant - Workday Payroll job at Surescripts in Arlington, VA

Remote role Full-time

Experienced Customer Service Representative – Delivering Exceptional Travel Experiences at blithequark

Remote role Full-time