New

Senior Medicare Compliance Program Manager

Mass General Brigham Health Plan
United States, Massachusetts, Somerville
399 Revolution Drive (Show on map)
Feb 17, 2026
Responsible for leading and overseeing the development, implementation, and monitoring of the MGB Health Plan's Medicare compliance program. This role involves ensuring adherence to regulatory requirements, mitigating risks, and fostering a culture of compliance within the organization. Essential Functions -Develop and implement MGB Health Plan's Medicare compliance program, including policies, procedures, and guidelines. -Conduct regular risk assessments related to Medicare compliance. -Identify potential areas of non-compliance and implement strategies to mitigate risks. -Collaborate with various health plan departments to ensure integration of compliance requirements into their processes. -Conduct investigations into potential compliance violations related to Medicare. -Prepare and submit required reports to regulatory bodies and authorities as necessary. -Review and update Medicare compliance policies and procedures regularly. Education Bachelor's Degree required; Master's Degree preferred Experience At least 5-7 years of experience in health plan compliance, with a focus on Medicare (Medicare Advantage and DSNP) regulations required Knowledge, Skills, and Abilities In-depth knowledge of Medicare rules, guidelines, and compliance expectations. Strong understanding of healthcare laws and regulations. Excellent communication and interpersonal skills. Proven experience in developing and implementing compliance programs. Detail-oriented with strong analytical and problem-solving skills. Working Conditions: This is a hybrid role that requires an on-site presence at the office in Assembly Row, Somerville roughly 2- 3x/month Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.