Compliance Manager – Medicare / Health Insurance

MyPlanAdvocate

43d•$80,000•Remote

About The Position

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.

Requirements

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).

Nice To Haves

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.

Responsibilities

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.
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.
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.