Senior Compliance Administrator - Network, Provider, Product (Medicare Compliance)

Location: Remote-MO, with other remote locations in Georgia, Virginia, Connecticut, Florida, New York, Texas, North Carolina, Illinois, and Kentucky; remote work within the United States.

Pay range: $87,700–$157,800 per year.

Company

hirify.global connects people with healthcare and supports more accessible and effective care for individuals, families, and communities.

What you will do

• Execute the Medicare Compliance Program in alignment with CMS, federal, state, and contractual requirements, supporting the prevention, detection, and correction of noncompliance and fraud, waste, and abuse.
• Translate regulatory requirements into actionable guidance and develop regulatory communications, issue summaries, disclosures, reports, attestations, and filings.
• Identify compliance risks, evaluate business processes, perform risk stratification, and recommend mitigation strategies.
• Lead or support issue identification, root cause analysis, corrective action plans, remediation validation, and assessment of reporting or disclosure requirements.
• Support audit and monitoring activities, including audit scope development, testing strategies, regulatory reviews, and ongoing audit readiness.
• Contribute to compliance training, policy and procedure reviews, cross-functional initiatives, regulatory monitoring, and collaboration with legal, audit, compliance, and operational partners.

Requirements

• Bachelor’s degree in a related field such as healthcare administration, public health, or policy, or equivalent experience.
• 5+ years of compliance, regulatory, operations, or risk management experience within a regulated industry such as healthcare, managed care, insurance, or the public sector.
• 4+ years of compliance advisory experience, including regulatory research, drafting compliance guidance, risk assessment, issue tracking, auditing or monitoring, and oversight of corrective action plans.
• 2+ years of experience supporting managed care, Medicare Advantage/Part D, or Dual Eligible (DSNP) programs.
• Foundational knowledge of Medicare regulations, including CMS guidance and compliance expectations for Parts C and D.
• Strong written and verbal communication skills.
• Strong analytical, organizational, and documentation skills with attention to detail.
• Ability to manage multiple assignments and meet deadlines in a fast-paced environment.

Nice to have

• Master’s degree or Juris Doctor.
• Certified in Healthcare Compliance (CHC).
• Familiarity with CMS audit protocols, program audits, or monitoring activities.
• Experience working in a matrixed or cross-functional environment.

Culture & Benefits

• Flexible remote, hybrid, field, or office work schedules.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Competitive pay adjusted for skills, experience, education, job-related factors, and employment status.
• Commitment to equal opportunity, diversity, and consideration of qualified applicants in accordance with applicable law.