Medicare Compliance Specialist @ eHealth, Inc. | Jobright.ai
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Medicare Compliance Specialist jobs in United States
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eHealth, Inc. · 6 hours ago

Medicare Compliance Specialist

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Responsibilities

With supervision from the Medicare Compliance Management team, execute the tasks associated with the compliance investigation process and compliance monitoring. These tasks include but are not limited to, the retrieval of written agent statements for allegations received, responding to Carrier requests, and conducting a thorough investigation of sales allegations identifying any compliance concerns, and accurate documentation throughout the investigation process.
Track complaints in the Medicare Compliance database and link all relevant documents. Assist the Management team with internal reporting of complaints; populating reports that demonstrate complaint volume, complaint investigation statuses and outcomes.
With supervision from the Medicare Compliance Management team, execute compliance monitoring (CM) assessments of sales agents, document results within established repository in accordance with defined departmental policies and procedures, report CM Assessment results to the Medicare Compliance Management.
Works with call center business units to increase awareness of the importance of the compliance, FWA plans and the Code of Conduct.
Maintain up-to-date knowledge of all Centers for Medicare & Medicaid (CMS) regulations.
Other tasks and duties as assigned

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Medicare Advantage experienceCompliance investigationRisk assessment knowledgeMicrosoft WordMicrosoft ExcelMicrosoft PowerPointMicrosoft SharePointMicrosoft OutlookPrioritize work

Required

Two (2) years prior experience at a Medicare Advantage Organization or Prescription Drug plan Sponsor (prior experience with Appeals and Grievances strongly preferred).
Knowledge of risk assessment concepts.
Must be detail-oriented with good organizational, written, and verbal communication skills.
Ability to work in a fast-paced environment and effectively prioritize work to meet internal and external deadlines.
Proficiency in Microsoft applications (Word, Excel, PowerPoint, SharePoint and Outlook).

Preferred

BA/BS Degree preferred.

Benefits

Annual performance bonus
Benefits designed to support employees’ personal and professional wellness

Company

eHealth, Inc.

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We’re Matchmakers. For over 25 years, we’ve helped millions of Americans find the healthcare plan that fits their needs at a price they can afford.

H1B Sponsorship

eHealth, Inc. has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (10)
2022 (27)
2021 (47)
2020 (42)

Funding

Current Stage
Public Company
Total Funding
$578.7M
Key Investors
H.I.G. Capital
2021-01-29Post Ipo Equity· $225M
2020-03-02Post Ipo Equity· $227.5M
2019-01-22Post Ipo Equity· $126.2M

Leadership Team

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Phillip Morelock
SVP, Chief Digital Officer
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Raquel Alexander
VP eCommerce and Digital Marketing
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Company data provided by crunchbase
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