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SCAN

Not-for-profit Medicare Advantage plan for seniors

Medicare Compliance AI Program Manager

Regulatory Compliance & EthicsUpdated on Nov 11
Full-timeLong Beach, CA, USA

About the Job

Requirements

  • A bachelor's degree in Healthcare Administration, Business Administration, Information Systems, Compliance, Public Health, Health Informatics, Project Management, or a related field, or an equivalent combination of education and experience.
  • At least five years of progressive experience in healthcare compliance, Medicare Advantage, regulatory operations, program administration, business systems, technology implementation, project management, or a related field.
  • Demonstrated experience leading cross-functional initiatives, managing complex projects, and driving business process improvements.
  • Experience gathering business and technical requirements, coordinating user acceptance testing, developing reports, dashboards, and analytics, and supporting system implementations and enhancements.
  • Strong knowledge of Medicare Advantage, Part D, CMS regulations, or another highly regulated environment.
  • Strong knowledge of Medicare Advantage, Part D, healthcare compliance, and regulatory requirements.
  • Ability to translate regulatory and business requirements into actionable implementation plans, process improvements, and technology-enabled solutions.
  • Strong project and program management skills, including the ability to lead cross-functional initiatives and drive accountability without direct authority.
  • Demonstrated analytical and problem-solving skills, with the ability to interpret data, identify trends, and support informed decision-making.
  • Proficiency with technology, reporting, workflow automation, and emerging technologies, including artificial intelligence and data analytics.
  • Demonstrated experience improving processes through artificial intelligence and automation, specifically by building agents or workflows using tools such as Copilot, Claude, ChatGPT, or other low-code/no-code platforms.
  • Excellent verbal and written communication skills, with the ability to engage stakeholders at all levels of the organization.
  • Ability to manage multiple priorities in a fast-paced environment while maintaining attention to detail and meeting deadlines.
  • Strong collaboration and relationship-building skills, with the ability to work effectively across business, operational, and technical teams.
  • A background check is required.

Responsibilities

  • Lead and support compliance program administration activities, initiatives, and projects designed to strengthen the effectiveness, scalability, and maturity of the Compliance Program, including policies and procedures, training and education, departmental communications, compliance investigations, and reporting.
  • Identify opportunities to use technology, analytics, workflow automation, and artificial intelligence to improve Compliance Program effectiveness, operational efficiency, and regulatory compliance; work with stakeholders to define and translate business requirements into systems specifications.
  • Support implementation, optimization, administration, and continuous improvement of compliance technology platforms, reporting solutions, regulatory libraries, and workflow management tools.
  • Coordinate and monitor implementation of federal and state regulatory requirements, ensuring actions are assigned, tracked, documented, and completed in collaboration with Compliance and business stakeholders.
  • Serve as a liaison between Compliance, business operations, and technology teams to facilitate project execution, regulatory implementation, and program initiatives.
  • Analyze compliance and operational processes to identify opportunities for standardization, optimization, automation, and continuous improvement.
  • Develop and maintain dashboards, reports, metrics, and data-driven insights that support compliance oversight, program performance monitoring, and leadership decision-making.
  • Translate regulatory, compliance, and business requirements into implementation plans, process improvements, system enhancements, and technology-enabled solutions.
  • Facilitate workgroups, stakeholder meetings, and governance activities; monitor project milestones, risks, dependencies, and implementation outcomes.
  • Develop implementation documentation, training materials, communication plans, and user adoption strategies to support successful deployment of program initiatives and technology solutions.
  • Actively support the achievement of SCAN’s Vision and Goals.
  • Perform other duties as assigned.

Desired Qualifications

  • Experience leveraging technology, workflow automation, analytics, and/or emerging technologies to improve operational efficiency and program effectiveness.

About the Company

SCAN

Not-for-profit Medicare Advantage plan for seniors

SCAN provides health coverage for seniors through Medicare Advantage and offers community programs like Independence at Home and Volunteer Action for Aging. Members enroll in SCAN’s Medicare Advantage plan to receive medical benefits, and SCAN also runs in-home care and community services that support aging in place, funded by the organization and partners. It differentiates itself as a not-for-profit with a long history (since 1977) focused on seniors and caregivers and backed by strong employee benefits and community engagement. The goal is to help seniors stay healthy and independent by improving access to care and strengthening the communities the organization serves.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Long Beach, CA
Founded
1977

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