Sr. Manager of Medicare Compliance

Centerfield

2d•$75,000 - $95,000•Remote

About The Position

QuoteManage is seeking an innovative, technology-driven Senior Manager, Medicare Compliance to lead compliance program administration, regulatory implementation, and technology enablement across our Medicare Advantage (MA), Part D, and Medigap distribution channels. In this role, you will bridge the gap between regulatory requirements and modern insurance technology. You will partner directly with Compliance, Business Operations, and Technology/Product teams to ensure CMS rules and state Department of Insurance (DOI) guidelines are seamlessly embedded into our sales workflows, telesales systems, CRM platforms, and AI quality assurance platforms. We seek a forward-thinking leader who leverages data analytics, workflow automation, and artificial intelligence to elevate program oversight, optimize agent efficiency, and drive continuous improvement.

Requirements

Bachelor’s Degree in Healthcare Administration, Business Administration, Information Systems, Compliance, Health Informatics, Project Management, or a related field (or equivalent combination of education and experience).
5+ years of progressive experience in healthcare compliance, Medicare Advantage (Part C & D), regulatory operations, business systems, or technology implementation.
Strong knowledge of CMS Medicare Marketing Guidelines (MMG), TPMO regulations, telesales compliance, and health plan partner standards.
Demonstrated experience gathering business/technical requirements, supporting software/system deployments, and developing data dashboards and analytics.

Responsibilities

Identify and execute opportunities to leverage technology, advanced analytics, workflow automation, and artificial intelligence (e.g., real-time agent guidance, speech analytics, automated auditing tools) to strengthen compliance oversight and operational efficiency.
Support the implementation, administration, optimization, and continuous improvement of compliance technology platforms, regulatory libraries, QA solutions, and workflow management tools.
Translate complex regulatory mandates into technical business requirements, system specifications, sales scripts, and automated compliance rules inside CRMs and dialing systems.
Lead and manage core compliance program administration activities to enhance the maturity, effectiveness, and scalability of QuoteManage’s compliance framework.
Direct compliance investigations, corrective action plans (CAPs), departmental communications, and regulatory reporting across captive (W2) and independent (1099) sales channels.
Maintain expert-level knowledge of CMS regulations, Third-Party Marketing Organization (TPMO) rules, Scope of Appointment (SOA) mandates, and call recording requirements.
Develop, maintain, and analyze compliance dashboards, KPIs, and metrics to provide leadership with actionable insights into agent performance, risk trends, and program effectiveness.
Conduct root-cause analysis on compliance deviations, agent misrepresentation allegations, and customer grievances (CTM/CMS complaints) to drive systemic solutions.
Coordinate, track, and monitor the end-to-end implementation of federal (CMS) and state regulatory changes across sales, marketing, and operations.
Develop implementation documentation, training materials, communication plans, and user adoption strategies to ensure operational teams successfully adopt compliance technologies and process enhancements.
Serve as the primary compliance liaison between Business Operations, Sales Leadership, Quality Assurance, and Engineering/Tech teams to facilitate project execution and regulatory alignment.
Facilitate workgroups, governance meetings, and stakeholder sessions; proactively manage project milestones, risks, dependencies, and business outcomes.
Analyze operational and sales workflows to standardize, optimize, and streamline compliance checkpoints without creating friction for sales agents.