Med Supp (Medigap) Compliance Program Manager

SCAN Health Plan • Long Beach, CA

20d • Hybrid

About The Position

The Med Supp (Medigap) Compliance Program Manager provides independent oversight of assigned components of the Medicare Advantage and Prescription Drug (MAPD) compliance program, with primary responsibility for compliance oversight of the Medigap product and state Department of Insurance regulatory requirements. The role ensures applicable federal and state requirements are effectively implemented, monitored, and maintained, while identifying, assessing, and escalating compliance risks. This position partners with business and operational teams to provide regulatory guidance, evaluate compliance controls, support regulatory readiness, and oversee implementation of state insurance regulatory requirements.

Requirements

• Bachelor's degree or equivalent combination of education and experience.
• 5+ years of healthcare compliance, regulatory affairs, audit, risk management, Medicare, Medigap, or related experience.
• Experience interpreting and implementing federal and state regulatory requirements.
• Experience conducting compliance risk assessments and providing regulatory guidance to business stakeholders.
• Experience supporting regulatory examinations, audits, investigations, or corrective action activities.
• Medicare Advantage, Part D, and/or Medigap experience.
• Experience working with state Departments of Insurance and state regulatory requirements.
• Experience supporting regulatory examinations, market conduct reviews, audits, or corrective action plans.
• Experience leading cross-functional initiatives in a highly regulated healthcare environment.
• Regulatory Expertise: Strong knowledge of Medicare, Medigap, and state insurance regulatory requirements, including Department of Insurance regulations and consumer protection standards.
• Analytical and Critical Thinking: Ability to interpret complex regulatory requirements and translate them into operationally actionable compliance obligations.
• Problem Solving Skills: Strong compliance risk assessment and problem-solving skills, with the ability to identify, evaluate, and escalate regulatory risks.
• Effective Written & Verbal Communication: Excellent written and verbal communication skills, with the ability to effectively communicate regulatory requirements and compliance risks to various audiences, including senior leadership.
• Advisory & Consultative Skills: Ability to lead cross-functional initiatives and influence stakeholders across Compliance, Legal, Product, Operations, Claims, Enrollment, Marketing, and Member Services.
• Organizational & Time Management Skills: Strong ability to manage multiple priorities, work independently, make risk-based decisions and ability to manage competing demands in a dynamic, highly regulated environment.
• State Insurance Regulatory Knowledge: Knowledge of Washington and/or Oregon Department of Insurance regulations, regulatory processes, filings, examinations, and compliance requirements applicable to Medicare and Medigap products.
• Stakeholder Influence & Relationship Management: Ability to influence and collaborate effectively across business units without direct authority, build consensus, navigate complex organizational dynamics, and drive compliance outcomes through partnership and effective communication.

Nice To Haves

• Curious about AI and its power to transform how we operate and serve our members.

Responsibilities

• Accountable for oversight of assigned Medigap and state regulatory affairs compliance domains, partnering with business stakeholders to ensure regulatory requirements are effectively implemented, monitored, and maintained.
• Monitor and assess federal and state regulatory requirements in collaboration with Legal Affairs and operational partners to assess compliance impact, clarify expectations, and support business understanding of regulatory changes and updates.
• Serve as the subject matter expert on Medigap requirements, including guaranteed issue rules, enrollment rights, underwriting restrictions, product disclosures, and state-specific market requirements.
• Assess how changes in Medigap regulation may impact Medicare Advantage enrollment, member behavior, and business strategy.
• Coordinate the implementation of Department of Insurance regulatory requirements across business areas, ensuring timely and effective compliance with state insurance obligations.
• Support regulatory examinations, audits, inquiries, and market conduct reviews, which includes coordinating responses to regulatory requests and findings
• Lead regulatory interpretation and compliance impact assessments for new and evolving requirements; translate regulatory guidance into clear compliance expectations and advisory support for business areas.
• Recommend new or revised compliance policies, standards, and controls to support regulatory requirements and sustainable compliance in an evolving business environment, demonstrating the ability to lead through ambiguity.
• Provide compliance guidance and targeted education to assigned functional areas by contributing to training materials, presentations, and educational sessions that reinforce regulatory expectations, while maintaining independence from training administration and tracking.
• Partner with business units and stakeholders to facilitate implementation of compliance requirements, provide regulatory guidance, support issue resolution, and escalate compliance risks as appropriate.
• Actively support the achievement of SCAN’s Vision and Goals.
• Other duties as assigned.

Benefits

• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO) along with 11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer days
• Excellent 401(k) Retirement Saving Plan with employer match
• Robust employee recognition program
• Tuition reimbursement
• An opportunity to become part of a team that makes a difference to our members and our community every day!

What This Job Offers

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