Medicare Compliance & Quality Assurance Associate

Summary

Spark is hiring an Associate, Medicare Compliance & Quality Assurance responsible for supporting the organization’s compliance operations by managing case intake, tracking case progress, facilitating communication between carriers and agents, and assisting with agent coaching. This role plays a critical part in ensuring timely resolution of compliance matters, maintaining accurate documentation, and promoting adherence to regulatory and internal standards.

The position reports to the Medicare Compliance & Quality Assurance Supervisor and partners closely across Platform, Contracting, Finance, and Sales teams to maintain the highest standards of compliance across Spark’s agent network.

What You'll Do 

• Compliance Case Management & Quality Assurance (80%)

  • Manage the complete lifecycle of CTM and Non-CTM compliance cases, including intake, investigation, communication, resolution, and formal closure.
  • Triage and respond to compliance-related emails and inquiries in Intercom, ensuring timely routing to the correct case type and queue.
  • Maintain accurate case records in the case management system and ensure timely documentation of notes, evidence, and required follow-up actions.
  • Act as the primary liaison with agents, agencies, internal teams, and carriers to ensure clear and timely communication throughout the case process.
  • Monitor case progress, send reminders, and escalate issues as needed to prevent delays and mitigate compliance risks.
  • Ensure all necessary information is provided to carriers and verify that all steps are completed before closing cases to support audit readiness.
  • Conduct case audits as needed to verify documentation accuracy, completeness, and adherence to case handling standards.

• Agent Coaching & Support (10%)

  • Provide targeted coaching and guidance to agents on compliance requirements, documentation standards, and best practices based on identified risks or performance gaps.
  • Educate agents on policies, procedures, and necessary corrective actions aligned with case findings.
  • Identify recurring compliance issues and escalate trends to leadership for broader coaching or training initiatives.
  • Assist agents and agencies with carrier compliance audits and provide preparation support.
  • Support agents in navigating carrier portals through self-service guides and direct assistance.
  • Maintain records of coaching participation, track completion metrics, and flag gaps requiring follow-up.

• Operational Support (10%)

  • Maintain organized, accurate, and audit-ready records for all compliance interactions and case activities.
  • Prepare basic compliance reporting as needed, including case volume, status, and turnaround summaries and key compliance indicators.
  • Collaborate with the compliance team on special projects, process improvements, and the development or refinement of new workflows.
  • Support additional compliance-related requests assigned by leadership, ensuring flexibility and responsiveness to priorities.
  • Remain agile and adaptable in the continually evolving Medicare regulatory landscape, adjusting processes and support practices as standards change.

What We're Looking For

• Comfort using tools such as Intercom, Excel, Airtable, CRM systems, or case management platforms (training provided).
• Ability to maintain accurate notes, records, and case information with strong attention to detail.
• Basic analytical abilities to assist with data reviews, quality assurance activities, and case audits.
• Ability to learn new technology, systems, and compliance tools quickly.
• Solution-oriented mindset with a strong interest in problem-solving and supporting agents through compliance challenges.
• Eager to learn and stay current as Medicare regulations and compliance requirements evolve.
• Clear communicator who can break down information simply and effectively.
• Collaborative and team-focused, with the ability to partner across Compliance, Sales, Platform, and other internal teams.
• Adaptable and flexible in a fast-paced, continually changing environment.
• Demonstrates strong ethics, integrity, and respect for confidentiality.

Compensation

Base Salary 60000 - 70000 USD