Medicare Compliance Project Manager

SCAN Health Plan • Long Beach, CA

1d • Hybrid

About The Position

The Medicare Compliance Project Manager supports and leads the organization’s regulatory audit readiness and execution activities, with a focus on external audits conducted by CMS and other federal and state regulators. They serve as a key coordination resource and central point of accountability for audit lifecycle management, including readiness preparation, audit response coordination, and corrective action plan (CAP) development, tracking, and validation. This role partners across business areas to ensure audit materials are accurate, complete, and defensible, and that compliance issues are consistently tracked, escalated, and resolved in alignment with regulatory expectations. We seek Rebels who are curious about AI and its power to transform how we operate and serve our members. Actively support the achievement of SCAN’s Vision and Goals. Other duties as assigned.

Requirements

• Bachelor's Degree or equivalent combination of education and experience.
• 3-5 years of experience in healthcare compliance, auditing, regulatory affairs, risk management, project management, or a related field.
• Experience coordinating complex projects involving multiple stakeholders and competing deadlines.
• Experience supporting audits, examinations, corrective action plans, or compliance oversight activities.
• Strong organizational, analytical, and communication skills.
• Experience supporting CMS Program Audits, Financial Audits, Validation Audits, or other federal or state regulatory reviews.
• Experience developing, tracking, validating, or monitoring corrective action plans (CAPs).
• Experience supporting compliance issue management, audit readiness, or regulatory response activities.
• Experience maintaining audit universes, evidence inventories, or regulatory documentation repositories.

Nice To Haves

• Project Management Professional (PMP), Certified Healthcare Compliance (CHC), Certified Compliance & Ethics Professional (CCEP), or Certified Internal Auditor (CIA) certification preferred

Responsibilities

• Support enterprise audit readiness activities, including preparation and organization of documentation, maintenance of audit universes, and management of supporting evidence to ensure accuracy, completeness, and defensibility. Participate in readiness reviews and mock audit activities.
• Assist with quarterly review and validation of program audit universes to ensure data integrity, completeness, and alignment with CMS expectations. Identify gaps and coordinate updates with business owners.
• Lead coordination of regulatory audits (CMS, federal, and state) from intake through close, including tracking requests, managing deliverables, and facilitating communication across business areas to ensure timely and accurate responses
• Compile, review, and support submission of audit documentation to ensure consistency, clarity, and alignment with regulatory expectations.
• Support development of CAPs by documenting findings, assisting with root cause analysis, and ensuring corrective actions align with regulatory expectations and internal standards.
• Track CAP activities through completion, maintain status updates, and follow up with business owners to support timely remediation and audit closure.
• Lead the internal validation process to confirm corrective actions have been fully implemented and are operating effectively. This includes conducting case file reviews, assessing updated policies and procedures, and evaluating training materials and supporting documentation to ensure sustained compliance and readiness for validation audits and closeout.
• Support intake and tracking of potential compliance issues identified through audits, monitoring activities, or other sources. Ensure issues are appropriately documented and escalated.
• Assist in evaluating and transitioning validated compliance issues into formal CAPs, ensuring consistency and alignment with compliance program processes.
• Prepare audit status updates, summaries, and materials for the Enterprise Compliance Committee and other governance forums. Develop and maintain audit readiness dashboards, status reports, risk logs, and project plans to support leadership visibility, regulatory readiness, and effective audit governance.

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
• Education Level: Associate degree