Compliance Analyst
For over 50 years, AmeriLife has been a leader in the development, marketing and distribution of annuity, life and health insurance solutions for those planning for and living in retirement. Associates get satisfaction from knowing they provide agents, marketers and carrier partners the support needed to succeed in a rapidly evolving industry.
About the role
The Compliance Analyst plays a critical role in ensuring the organization adheres to the regulatory requirements governing Medicare Advantage (MA) and Part D programs. This position is responsible for monitoring CMS regulatory updates, supporting audit readiness, conducting compliance reviews, and helping operational teams interpret and implement Medicare guidance. The analyst serves as a key contributor to the organization’s compliance program by maintaining documentation, identifying risks, and strengthening oversight efforts. The ideal candidate combines strong analytical skills with attention to detail and an ability to communicate regulatory information clearly across departments.
Responsibilities
- Monitor & Interpret Medicare Regulations
- Review, analyze, and interpret CMS, Medicare Advantage, and Part D regulatory updates to assess operational impacts.
- Maintain awareness of carrier notifications and CMS guidance to support organizational compliance.
- Provide Regulatory Guidance to Internal Teams
- Communicate regulatory changes and compliance expectations to functional areas such as sales, billing, clinical teams, and operations.
- Support business units in applying CMS rules to processes and workflows.
- Compliance Documentation & Reporting
- Maintain compliance tracking logs, regulatory files, and required documentation in alignment with CMS program elements.
- Prepare compliance status reports for leadership, audit teams, and regulatory bodies.
- Internal Audits & Risk Monitoring
- Conduct internal compliance reviews to assess adherence to Medicare program requirements.
- Identify potential compliance gaps, evaluate risks, and recommend corrective action.
- Audit Coordination & Response
- Assist in preparing responses to CMS or carrier audit requests by gathering evidence and supporting documentation.
- Track audit activities, deadlines, and remediation progress.
- Operational Compliance Integration
- Review operational workflows to confirm alignment with Medicare requirements.
- Collaborate with cross-functional teams to reinforce compliance expectations.
- Training & Education Support
- Assist in developing and delivering Medicare compliance and FWA training for staff and contracted partners.
- Maintain training logs and verify completion of required CMS modules.
- Fraud, Waste & Abuse (FWA) Monitoring
- Support investigations into compliance concerns and potential FWA cases.
- Perform or validate monthly exclusion list screenings (OIG/GSA) and escalate issues.
- CMS & Carrier Liaison Support
- Assist in communications with Medicare Advantage and Part D carriers regarding compliance expectations.
- Support responses to CMS inquiries and operational oversight activities.
Requirements
- Bachelor’s degree in healthcare administration, business, public health, regulatory affairs, or a related field.
- Compliance certifications (e.g., CHC, CPCO, CHPC) preferred but not required.
- 2–4 years of experience in Medicare compliance, auditing, regulatory oversight, or health plan operations.
- Experience with Medicare Advantage and/or Part D carrier compliance requirements is highly beneficial.
Skills
- Technical & Analytical Skills
- Ability to interpret complex CMS regulations and identify compliance risks.
- Strong analytical capability for audits, compliance reviews, and regulatory analysis.
- Communication & Collaboration
- Strong written and verbal communication skills to translate regulatory requirements for diverse internal teams.
- Ability to work collaboratively across departments, providing guidance and support.
- Organizational Skills
- High attention to detail; ability to maintain complete and accurate compliance records.
- Strong time-management skills with the ability to manage multiple priorities.
- Problem-Solving
- Ability to identify compliance issues and develop well-reasoned recommendations.
- Technical Tools
- Proficiency with Microsoft Office Suite and compliance tracking tools commonly used for regulatory reporting and audits.
- Regulatory Knowledge
- Working knowledge of CMS regulations, Medicare Advantage and Part D program requirements, and carrier compliance standards.
- Familiarity with fraud, waste, and abuse (FWA) requirements and CMS audit protocols.
Benefits
- Comprehensive benefits package including PTO, medical, dental, vision, retirement savings, disability insurance, and life insurance.