DevotedHiring

Claims Compliance Program Manager

  • USD 73,000 to 130,000 per year
  • Remote, United States
  • Lead
  • Posted 3 days ago
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In one line

Compliance program manager for claims operations, watching audit readiness and quality metrics across Medicare Advantage and Medicaid plans; remote.

About the role

Ownership covers audit coordination, issue tracking and policy upkeep across claims, payment integrity and compliance groups. Success looks like clean audits, timely remediation and tighter controls.

At a glance

Pay
USD 73,000 to 130,000 per year
Remote scope
Remote, United States
Seniority
Lead
Skills
Jira, Claims adjudication, Medicare Advantage, Medicaid, SOPs, Data validation
Posted
26 Oct 2026
Last checked
27 Oct 2026

What you will do

  • Track claims compliance metrics and reports, spotting trends, risks and gaps
  • Coordinate and document internal, financial and regulatory audits
  • Analyze claims data for discrepancies and recurring problems
  • Log issues, deliverables, Jira tasks and audit findings, then push them to closure
  • Support quality assurance workflows, operational reporting and data validation
  • Draft and refresh policies, procedures and compliance materials

What they look for

  • Able to juggle several priorities and keep compliance deliverables on schedule
  • Clear written and verbal communication with cross functional stakeholders
  • Skilled at drafting structured compliance reports and audit documentation
  • Experience writing and standardizing SOPs, policies and workflow docs
  • Bachelor's degree or equivalent work experience

Nice to have

  • Background in healthcare, health technology or tech operations

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Claude

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Muse

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Muse is available in the US only for now.

Prompt
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Questions about this job

Is this job fully remote, and from where?

The posting lists it as remote for people in the United States.

What does this job pay?

The posting states USD 73,000 to 130,000 per year.

What experience is needed?

It is a lead role. The posting asks for: able to juggle several priorities and keep compliance deliverables on schedule; clear written and verbal communication with cross functional stakeholders; skilled at drafting structured compliance reports and audit documentation. Skills it names include Jira, Claims adjudication, Medicare Advantage, Medicaid.

How do I apply with Keywordise AI?

Select Apply with Keywordise AI, sign up and upload your CV. Keywordise writes a CV and a cover letter for this job from your real experience and applies for you. The 7-day free trial needs no card.

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