Medicare Advantage Compliance Specialist
RAM Health · United States · US
Regulatory Affairs
Remote
Dentist
Demand80
Career growth72
Healthcare fit80
Remote potential100
Salary band
USD 85k – 90k
5-year outlook
Demand for Medicare Advantage and Medicaid compliance specialists should remain stable as CMS rules, audits, and regulatory scrutiny continue. Compensation will vary by experience, location, and health plan size, with fully remote roles likely remaining competitive.
Clinical license
Not required
Applicant reach
moderate
Seniority
mid
Employment type
full-time
Date found
2026-10-30
Intelligence details
Flexible work details
- Engagement type
- Permanent
- Hours
- Full-time
- Eligible countries
- United States
- Profession fit
- Dentist
- Rate period
- Annual
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Worth applying for clinicians with compliance, quality, audit, utilization review, or Medicare Advantage exposure who want a fully remote regulatory role. Clinicians without direct healthcare compliance experience may find the 3-4 year specific experience requirement a significant barrier.
Who should apply
Nurses, doctors, pharmacists, IMGs, and healthcare graduates with experience in Medicare Advantage, Medicaid managed care, quality improvement, utilization review, audit preparation, HIPAA/FWA programs, regulatory policy, or health plan operations.
CV angle
Frame clinical and quality work as compliance-adjacent: CMS/Medicare Advantage exposure, policy interpretation, audit preparation, corrective action plans, HIPAA/FWA training, monitoring, documentation, and cross-functional collaboration. Quantify audits, training compliance, remediation projects, or regulatory monitoring work without inventing compliance titles.
Skills to highlight
- Medicare Advantage and Managed Medicaid regulatory knowledge
- CMS guidance interpretation
- Compliance monitoring and auditing
- Root cause analysis and corrective action plans
- OIG/GSA exclusion screening
- HIPAA and FWA program support
- Audit readiness and external audit support
- Reporting dashboards and trend analysis
Role summary
A fully remote health plan compliance role focused on monitoring CMS and state regulatory requirements, supporting RCA/CAP development, conducting exclusion screening, tracking compliance training, and helping Medicare Advantage and Managed Medicaid plans maintain audit-ready compliance programs.
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