This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Medicare Compliance & QA Associate based in the United States.
This role supports critical Medicare compliance operations within a fast-growing healthcare technology environment.
You will manage compliance cases from intake through investigation, resolution, documentation, and closure.
The position combines quality assurance, case management, agent support, and operational reporting.
You’ll work closely with agents, carriers, and cross-functional teams to ensure regulatory and internal standards are consistently met.
The role offers an opportunity to identify recurring compliance risks and help improve processes, coaching, and workflows.
You’ll join a collaborative, mission-driven team using technology to make Medicare easier to navigate for advisors and beneficiaries.
This is a strong opportunity for a detail-oriented professional who wants meaningful responsibility in a rapidly evolving healthcare environment.
Accountabilities:
- Manage the full lifecycle of CTM and Non-CTM Medicare compliance cases, including intake, investigation, communication, resolution, documentation, and formal closure.
- Triage compliance-related emails and inquiries, ensuring they are accurately categorized and routed to the appropriate case type and queue.
- Maintain complete, accurate, and audit-ready case records, including notes, evidence, follow-up actions, and required documentation.
- Serve as a key point of contact for agents, agencies, carriers, and internal stakeholders throughout the compliance case process.
- Monitor case progress, follow up on outstanding actions, and escalate issues when necessary to prevent delays and reduce compliance risk.
- Conduct case audits to verify documentation quality, completeness, and adherence to established case-handling standards.
- Provide targeted coaching to agents on compliance requirements, documentation practices, corrective actions, and carrier expectations.
- Identify recurring compliance issues and escalate trends to leadership to support broader coaching and training initiatives.
- Assist agents and agencies with carrier compliance audits and provide guidance for navigating carrier portals and self-service resources.
- Track coaching participation and completion metrics, identifying gaps that require additional follow-up.
- Prepare compliance reporting covering case volumes, status, turnaround times, and other relevant performance indicators.
- Partner with Compliance, Sales, Platform, Contracting, Finance, and other teams on process improvements, special projects, and new workflows.
- Maintain flexibility as Medicare regulations and operational requirements evolve, adapting processes and support practices accordingly.
Requirements:
- Experience working with tools such as Intercom, Excel, Airtable, CRM platforms, or case management systems; experience with these tools is valuable, with training available where needed.
- Strong attention to detail and the ability to maintain accurate records, notes, evidence, and case information.
- Basic analytical skills with the ability to review data, support quality assurance activities, identify discrepancies, and assist with case audits.
- Ability to learn new technologies, systems, and compliance processes quickly.
- Knowledge of Medicare or other health insurance products is advantageous, particularly experience working with Medicare compliance requirements.
- Strong written and verbal communication skills, with the ability to explain policies, requirements, and corrective actions clearly.
- A solution-oriented approach and genuine interest in helping agents navigate compliance challenges effectively.
- Strong organizational skills and the ability to manage multiple cases, deadlines, and follow-up activities simultaneously.
- Collaborative mindset with the ability to work effectively across Compliance, Sales, Platform, and other internal teams.
- Adaptability and comfort working in a fast-paced environment where regulations, priorities, and processes may change.
- High ethical standards, integrity, discretion, and respect for confidential information.
- Experience coaching colleagues, supporting team development, or providing guidance on policies and procedures is a plus.
- Ability to work remotely from an approved location within the United States and maintain employment eligibility in the U.S.
Benefits:
- Base salary: $60,000–$70,000 USD annually.
- Equity compensation opportunities.
- Comprehensive healthcare coverage, including medical, dental, and vision.
- 401(k) plan.
- Flexible work location with coworking options available.
- Paid time off and 11 paid holidays.
- Monthly remote-work stipend to help cover home-office expenses.
- Paid parental leave, including up to 14 weeks for birthing parents and 8 weeks for non-birth parents.
- Two-week paid sabbatical after five years of employment.
- Wellbeing benefits and perks through programs supporting mental health, primary care, lifestyle, and financial wellness.
- Opportunity to work remotely within approved U.S. locations as part of a fast-growing, mission-driven healthcare technology environment.
- Opportunities to learn, grow, and contribute to process improvements with meaningful impact on Medicare advisors and beneficiaries.
How Jobgether works:
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
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