Director Medicare Compliance Officer

St. Joseph Hospital & Medical Center • Phoenix, AZ

1d • $50 - $74 • Onsite

About The Position

As the Medicare Compliance Officer (MCO) for Mercy Care Plan, managed by Aetna, a CVS Company, you will be the cornerstone of our Medicare Advantage (Part C) and Medicare Part D compliance efforts. This critical leadership role is responsible for designing, implementing, and rigorously overseeing a comprehensive compliance program, ensuring unwavering adherence to all applicable federal and state regulations, as well as CMS requirements. Everyday your expertise will safeguard the integrity and operational compliance of all Medicare-related activities within Mercy Care Plan and you will play a pivotal role in cultivating a culture of compliance and ethical conduct, serving as a trusted advisor and strategic leader. To be successful in this position you will maintain strong daily operational alignment with the Medicare team while holding direct reporting accountability to the CEO and the Audit and Compliance Committee of the Board, providing a direct and elevated voice for compliance.

Requirements

• Bachelors Other or an equivalent combination of directly related work experience and/or education
• Five (5) years of experience that demonstrates solid Medicare compliance program development, operation and administration responsibilities

Nice To Haves

• None

Responsibilities

• Deliver comprehensive formal reports to the Board, CEO, and Compliance Committee quarterly (or as needed) on program status, issue resolution, and oversight activities, offering critical insights.
• Oversee the annual Board Code of Conduct and compliance training, including design, content, distribution, and tracking, ensuring full regulatory and organizational adherence.
• Develop mechanisms encouraging confidential reporting of suspected fraud, waste, abuse (FWA), or misconduct, with strong protection against retaliation.
• Promptly respond to FWA reports, coordinating internal investigations, developing corrective actions, and collaborating closely with Internal Audit and SIU.
• Flexibly manage internal investigations and implement corrective measures (e.g., policy enhancements, disciplinary actions) to ensure compliance and mitigate risk.

What This Job Offers

• Job Type: Full-time
• Career Level: Director