Govt Progs Compliance Consultant (Medicare Part D) - Remote
Chicago, Illinois, United States · Remote OK
$62k–$136k/yr
Mid level
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Govt Progs Compliance Consultant (Medicare Part D) - Remote
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$62k–$136k/yr
Full-time
bachelor degree
Health and wellness benefits, 401(k) savings plan, Pension plan, Paid time off, Paid parental leave, Disability insurance
Posted 3d ago
~40 hrs/week
Remote in Nashville, Tennessee, United States
Responsibilities
This role supports the evaluation of Medicare regulatory requirements and CMS guidance to assess compliance risks for government contracts. The consultant will act as a subject matter expert to ensure regulatory requirements are implemented across internal operations and delegated entities.
Requirements
Candidates must have a bachelor's degree and at least 3 years of experience in health plans, regulatory compliance, or risk management. Proficiency in Microsoft Office and strong communication skills are required to collaborate with business units and government agencies.
Full job description
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
Job Summary
This position is responsible for supporting the evaluation of Government Programs (Medicare) regulatory requirements and CMS guidance to assess compliance risks associated with HCSC government contracts. Will serve as a subject matter expert (SME) to assist in evaluation of Medicare regulations and ensure regulatory requirements are implemented accurately and timely across internal operations and assigned First Tier, Downstream, and Related Entities (FDRs). Assists in overseeing operational compliance through activities such as universe and report reviews, attendance at operational meetings, and targeted monitoring of high-risk areas of concern. Responsibilities include identifying, assessing, and escalating compliance risks and issues, partnering with stakeholders to develop, implement, and monitor effective mitigation and remediation strategies. This role collaborates closely with other compliance colleagues, business partners, leadership, governmental agencies, and FDRs. Additional responsibilities include supporting Part D and FDR compliance activities as needed, fostering strong cross-functional relationships, liaising between Compliance and business teams, and performing other duties as assigned.
Required Job Qualifications:
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 to include Word, PowerPoint, and Excel.
Preferred Job Qualifications:
Government Programs Healthcare Compliance experience and equivalent experience.
Knowledge of Medicare Part D regulatory and operational requirements.
Government programs operational experience.
Certified Pharmacy Technician or Pharmacy related experience.
Experience with communicating regulatory requirements and compliance risk to senior leadership and business partners.
Experience working with PBMs or other delegated entities.
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Pay Transparency Statement:
At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From 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, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
HCSC Employment Statement:
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range
$61,500.00 - $136,100.00
Exact compensation may vary based on skills, experience, and location.
Empowering Member Health With Compassion and Innovation
Industry
Hospitals and Health Care
Company size
10,001+ employees
Headquarters
Chicago, IL
LinkedIn followers
168,776
Health Care Service Corporation serves nearly 23 million people across the United States through its portfolio of health benefit solutions.
HCSC provides health coverage options for employers large and small, individuals and families, and Medicare and Medicaid plans. HCSC also offers related health care products and services such as pharmacy solutions, life and dental insurance, and health data technology. A Mutual Legal Reserve Company, HCSC is an independent licensee of the Blue Cross Blue Shield Association.
For nearly a century, we have enabled and coordinated the access to quality care for millions of members. Our experience and industry knowledge establishes a solid foundation for our future—driving innovations that further expand access, improve health outcomes, and reduce costs.
Embedded within the fabric of how we operate is a deep sense of caring and commitment that informs how we serve our members, engage in local communities, and deliver positive change to the health care industry.
As health care needs evolve, we leverage our portfolio of companies to deliver differentiated value to all industry stakeholders so that, together, we make more possible.
Join HCSC and discover what new ways of thinking can mean for you, your community, our customers and our organization: HCSC.com/careers. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to an inclusive, drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability, or protected veteran status.
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How many Healthcare jobs are open in Nashville, TN right now?
There are currently 2,992 open healthcare positions in Nashville, TN listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Healthcare roles in Nashville, TN?
Companies currently hiring include Vanderbilt University Medical Center, Ascension, Tennessee Oncology, Nashville General Hospital, National HealthCare Corporation (NHC), among others. Browse the listings above to see every active employer.
Are there remote or hybrid Healthcare jobs in Nashville, TN?
Yes — 540 of the 2992 open healthcare positions offer remote or hybrid work (264 remote, 276 hybrid).
How do I apply for Healthcare jobs in Nashville, TN?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.