Govt Programs Compliance Consultant, Medicare Part D

🕒 August 24

🌽 Illinois, Oklahoma, +2 more states – Remote

🌽 Illinois – Remote 🌪️ Oklahoma – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote

💵 $61.5k - $136.1k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Health Care Service Corporation is an independent licensee of the Blue Cross Blue Shield Association, serving nearly 23 million people across the United States with a wide range of health benefit solutions. The company provides health coverage options for various groups, including employers, individuals, families, as well as Medicare and Medicaid plans. In addition to health insurance, HCSC offers services such as pharmacy solutions, life and dental insurance, and health data technology. With nearly a century of experience, HCSC is dedicated to improving access to quality care, enhancing health outcomes, and reducing costs while maintaining a deep commitment to its members and local communities.

📋 Description

• Support evaluation of Government Programs (Medicare) regulatory requirements and CMS guidance • Assess compliance risks associated with HCSC government contracts • Serve as a subject matter expert on Medicare regulations • Assist in ensuring regulatory requirements are implemented accurately and timely across internal operations and assigned First Tier, Downstream, and Related Entities (FDRs) • Support operational compliance through universe and report reviews, operational meeting attendance, and targeted monitoring of high-risk areas • Identify, assess, and escalate compliance risks and issues • Partner with stakeholders to develop, implement, and monitor mitigation and remediation strategies • Collaborate with compliance colleagues, business partners, leadership, governmental agencies, and FDRs • Support Part D and FDR compliance activities as needed • Foster cross-functional relationships and liaise between Compliance and business teams • Perform other duties as assigned

🎯 Requirements

• Bachelor’s degree and 3 years’ experience in health plans, regulatory compliance or risk management OR 6 years’ experience in health plans, regulatory compliance, or risk management • Ability to communicate with and build relationships with internal business units and/or various external government agencies • Critical thinking, risk assessment, and mitigation • Verbal and written communication skills • Ability to work with minimal supervision • Organizational, analytical, and decision-making skills • PC proficiency including Word, PowerPoint, and Excel • Government Programs Healthcare Compliance experience and equivalent experience preferred • Knowledge of Medicare Part D regulatory and operational requirements preferred • Government programs operational experience preferred • Certified Pharmacy Technician or pharmacy-related experience preferred • Experience communicating regulatory requirements and compliance risk to senior leadership and business partners preferred • Experience working with PBMs or other delegated entities preferred

🏖️ Benefits

• Curated development plans and professional development • Health and wellness benefits • 401(k) savings plan • Pension plan • Paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement • Annual incentive bonus plan, subject to plan terms and conditions • Other incentives