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Medicare Compliance Project Manager

$92.4k - $133.67k

SCAN Health Plan

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do.Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults.Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity.At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.The JobThe Medicare Compliance Project Manager supports and leads the organization’s regulatory audit readiness and execution activities, with a focus on external audits conducted by CMS and other federal and state regulators. They serve as a key coordination resource and central point of accountability for audit lifecycle management, including readiness preparation, audit response coordination, and corrective action plan (CAP) development, tracking, and validation.This role partners across business areas to ensure audit materials are accurate, complete, and defensible, and that compliance issues are consistently tracked, escalated, and resolved in alignment with regulatory expectations.You WillAudit Readiness Support – Support enterprise audit readiness activities, including preparation and organization of documentation, maintenance of audit universes, and management of supporting evidence to ensure accuracy, completeness, and defensibility. Participate in readiness reviews and mock audit activities.Audit Universe Maintenance & Validation – Assist with quarterly review and validation of program audit universes to ensure data integrity, completeness, and alignment with CMS expectations. Identify gaps and coordinate updates with business owners.Regulatory Audit Leadership & Coordination – Lead coordination of regulatory audits (CMS, federal, and state) from intake through close, including tracking requests, managing deliverables, and facilitating communication across business areas to ensure timely and accurate responsesAudit Documentation & Response Management – Compile, review, and support submission of audit documentation to ensure consistency, clarity, and alignment with regulatory expectations.Corrective Action Plan (CAP) Development Support – Support development of CAPs by documenting findings, assisting with root cause analysis, and ensuring corrective actions align with regulatory expectations and internal standards.CAP Tracking & Monitoring – Track CAP activities through completion, maintain status updates, and follow up with business owners to support timely remediation and audit closure.CAP Validation & Effectiveness ReviewLead the internal validation process to confirm corrective actions have been fully implemented and are operating effectively. This includes conducting case file reviews, assessing updated policies and procedures, and evaluating training materials and supporting documentation to ensure sustained compliance and readiness for validation audits and closeout.Potential Compliance Issue (PCI) Tracking – Support intake and tracking of potential compliance issues identified through audits, monitoring activities, or other sources. Ensure issues are appropriately documented and escalated.PCI to CAP Alignment – Assist in evaluating and transitioning validated compliance issues into formal CAPs, ensuring consistency and alignment with compliance program processes.Audit Reporting & Committee Support – Prepare audit status updates, summaries, and materials for the Enterprise Compliance Committee and other governance forums. Develop and maintain audit readiness dashboards, status reports, risk logs, and project plans to support leadership visibility, regulatory readiness, and effective audit governance.We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.Actively support the achievement of SCAN’s Vision and Goals.Other duties as assigned.Your Qualifications• Bachelor's Degree or equivalent combination of education and experience. • 3-5 years of experience in healthcare compliance, auditing, regulatory affairs, risk management, project management, or a related field. • Experience coordinating complex projects involving multiple stakeholders and competing deadlines. • Experience supporting audits, examinations, corrective action plans, or compliance oversight activities. • Strong organizational, analytical, and communication skills.• Experience supporting CMS Program Audits, Financial Audits, Validation Audits, or other federal or state regulatory reviews. • Experience developing, tracking, validating, or monitoring corrective action plans (CAPs). • Experience supporting compliance issue management, audit readiness, or regulatory response activities. • Experience maintaining audit universes, evidence inventories, or regulatory documentation repositories. • Project Management Professional (PMP), Certified Healthcare Compliance (CHC), Certified Compliance & Ethics Professional (CCEP), or Certified Internal Auditor (CIA) certification preferredYour Skills/AbilitiesRegulatory Audit ManagementAbility to coordinate multiple regulatory audits simultaneously, manage audit deliverables, and ensure timely and accurate responses.Project ManagementStrong organizational skills with the ability to manage competing priorities, deadlines, stakeholders, and dependencies.Corrective Action & Remediation OversightAbility to track, monitor, validate, and report remediation activities through completion.Analytical & Critical ThinkingAbility to analyze findings, identify root causes, evaluate evidence, and recommend practical solutions.Written & Verbal CommunicationAbility to communicate effectively with leadership, regulators, auditors, and business stakeholders.Relationship ManagementAbility to build credibility and foster productive working relationships across all levels of the organization.Regulatory Compliance KnowledgeWorking knowledge of healthcare regulatory requirements, auditing principles, and compliance program expectations.Data Management & DocumentationAbility to maintain accurate documentation, audit inventories, evidence repositories, and reporting tools to support audit readiness and regulatory compliance.What's in it for you?Base Pay Range: $92,400 to $133,671 annuallyWork Mode: Mostly Onsite (In office 2 days per week on Tuesday/Wednesday)An annual employee bonus programRobust Wellness ProgramGenerous paid-time-off (PTO) along with 11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer daysExcellent 401(k) Retirement Saving Plan with employer matchRobust employee recognition programTuition reimbursementAn opportunity to become part of a team that makes a difference to our members and our community every day!We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.#LI-JA1#LI-HybridEqual Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)SummaryLocation: Long Beach, CAType: Full time

Vacancy posted 2 days ago
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