Compliance - FDR Manager (Medicare)

TL;DR

Compliance - FDR Manager (Medicare): Auditing and monitoring First Tier, Downstream and Related Entities (FDRs) to ensure compliance with State, Federal, and Medicare Part C & D regulations with an accent on conducting desktop/onsite audits, creating reports and scorecards, and managing Corrective Action Plans. Focus on identifying non-compliance, driving resolutions, and meeting strict CMS deadlines in a remote-first environment.

Location: Remote USA

Salary Range: $75,000-$115,000

Company

All-in-one healthcare company combining health insurance, clinical care, service, and technology to deliver high-quality care for older Americans across the United States. Founded in 2017.

What you will do

• Monitor FDRs regularly as part of the Compliance Effectiveness Program
• Conduct desktop and onsite audits of FDRs
• Create audit reports, scorecards, and evaluation tools
• Issue Corrective Action Plans and ensure deficiencies are addressed
• Translate complex findings into clear presentations and reports for leadership and partners

Requirements

• 2–5 years of healthcare auditing or insurance operations experience with deep understanding of Medicare Part C & D standards
• Proven experience managing FDRs, identifying non-compliance, and driving resolutions
• Demonstrated ability to execute full audit process: desktop/onsite audits, reports, scorecards
• Skilled in issuing and managing Corrective Action Plans to fully remediate deficiencies
• Strong project management skills with track record of meeting CMS deadlines in remote-first environment

Nice to have

• Proficiency in Google Workspace (Docs, Sheets, Slides) and Slack
• Experience or interest in Generative AI or LLMs to automate audit tasks

Culture & Benefits

• Employer-sponsored health, dental, and vision plans with low or no premiums
• Generous paid time off and parental leave program
• $100 monthly mobile or internet stipend
• Stock options for all employees and bonus eligibility
• 401K program