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Medicare Program Manager

Must be located in or relocate to Baltimore or Albany area

Essential Functions

  • Serves as Project Manager for regulatory affairs projects related to new or updated regulatory guidance
  • Acts as the liaison with business areas to ensure appropriate changes are made to the impacted departments
  • Develops monitoring processes to ensure implementation is effective and compliant
  • Guides internal customers on strategies, methods, and options for achieving operational/functional requirements applicable to Versant Health and its’ clients commercial and state insurance regulated products
  • Keeps abreast of federal and state regulations pertaining to Medicare. Assesses the impact of Federal regulatory changes on the enterprise’s programs, clients, and health insurance plans
  • Ensures that communications regarding high-impact regulatory changes are provided to appropriate business areas and executive leadership
  • Assists in the review, development, revision and maintenance of compliance policies and procedures and ensures all business/operational policies are updated to comply with law and regulations
  • Provide leadership, support, guidance, and training to internal teams relative to the organizations participation in client or regulatory audits of Medicare programs
  • Collaborates with the Quality department to ensure that regulatory mandates, certain certifications, and survey responses are being tracked and monitored
  • Monitors changes in relevant regulatory areas
  • Develops and provides training and education on new or updated regulatory requirements for Compliance and other business areas as applicable
  • Supports the submission of regulatory filings and reporting requirements on an ongoing basis
  • Provides input into the process for the issuance, development, remediation, and validation of regulator-issued corrective action plans (CAPs) for identified and/or reported issues of non-compliance with Medicare requirements
  • Assists in the preparation of updates and reports to management, Board of Directors, and Compliance Committee related to regulatory affairs and related compliance activities
  • Ability to effectively lead interactive meetings both onsite and remotely on a regular and predictable basis

Education & Experience

  • Bachelor’s degree and a minimum of 5 + years’ experience providing Medicare regulatory subject matter expertise in a Medicare managed care, insurance or other highly regulated environment; or advanced degree in relevant discipline preferred but not required
  • A proven track record of collaborating effectively across all areas and levels of an organization is critical
  • An understanding of the regulatory environment, CMS Medicare program requirements, and CMS audits protocols is a must
  • Proficient at reading, analyzing and working with healthcare or other complex laws, regulations and requirements
  • Strong working knowledge of Microsoft Office applications, including Power Point, Excel and Visio


  • Ability to build rapport quickly and collaborate in a fast paced environment
  • Excellent written and verbal communications skills
  • Results oriented
  • Thoroughness
  • Excellent judgement
  • Self-sufficient and accountable
  • Strong organizational skill


Medicare Program Manager

Thank you for your interest in the Medicare Program Manager position. Please provide the information below and we will contact you to schedule a call if interested. This link will remain active until the position has been filled.
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