Senior Compliance Administrator - Clinical, SNP Model of Care, Care Management, Quality, STARs

Location: Remote-MO; other remote locations include GA, VA, WI, CT, MI, FL, NY, NC, IL, KY, and MN, United States

Salary: $87,700–$157,800 per year

Company

hirify.global provides healthcare services focused on connecting people with the care they need.

What you will do

• Execute the Medicare Compliance Program in alignment with CMS requirements and applicable federal and state regulations.
• Interpret regulatory and contractual requirements and translate them into actionable compliance guidance for business stakeholders.
• Prepare, validate, and submit regulatory reports, attestations, filings, inquiries, issue summaries, and disclosures.
• Identify compliance risks, perform root cause analysis, support audit and monitoring activities, and develop or evaluate corrective action plans.
• Partner with compliance, legal, audit, operational teams, external stakeholders, and regulators to support audits, regulatory reviews, and audit readiness.
• Contribute to compliance training, policy and process reviews, regulatory monitoring, cross-functional initiatives, and continuous improvement.

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 involving 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 Parts C and D compliance expectations.
• 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.
• Relevant licensure such as RN, LPN, Pharmacist, CPhT, or case management credentials.

Culture & Benefits

• Remote, hybrid, field, or office work schedules are supported depending on the role and circumstances.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Equal opportunity employment and commitment to diversity.
• Work focused on improving healthcare access and outcomes for individuals, families, and communities.