Senior Manager, Medicare Business Compliance

Responsibilities

• Oversee the implementation and ongoing interpretation of Medicare laws, regulations, and regulatory guidance, ensuring timely and accurate execution across impacted business areas.
• Serve as a subject matter resource for inquiries and lead responses to audit and data requests from regulators, auditors, and internal oversight partners.
• Interpret regulatory guidance, assess compliance gaps, identify root causes, and design and implement sustainable corrective action plans.
• Routinely communicate project status, risks, and outcomes to senior leaders and executive stakeholders, translating complex regulatory requirements into clear, actionable business guidance.
• Oversee new and updated regulatory guidance implementation, lead Annual Enrollment Period (AEP) readiness activities across multiple business areas, proactively identify and mitigate operational risks, and coordinate end‑to‑end audit and regulatory responses.
• Contribute to regulatory compliance, operational stability, and overall member satisfaction.

• Project Management: 5+ years of experience leading complex initiatives from planning through execution and delivery.
• Systems Expertise:
  Hands‑on experience with Quick Base.
• Communication
  
  Skills:
  
  Demonstrated strong oral and written communication skills.
• Executive Communication:
  Proven ability to communicate effectively with leaders at all levels, including executive leadership.
• Problem Solving & Decision Making:
  Strong analytical skills with the ability to assess issues, evaluate options, and make sound decisions.
• Collaboration & Teamwork:
  Adept at working collaboratively across cross‑functional teams to achieve shared goals.
• Growth Mindset:
  Demonstrated agility and commitment to continuous learning, development, and coaching of others.
• Execution & Delivery:
  Strong capability in planning, delivering, and supporting initiatives to achieve intended outcomes.
• Regulatory Expertise:
  Strong knowledge of Medicare regulations and regulatory guidance.
• Preferred Qualifications:
  
  5+ years Medicare operational experience, Aetna systems experience, and regulatory compliance experience.