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Medicare Compliance & QA Associate
Medicare Compliance & QA AssociateSpark Advisors • Lancaster, PA, US
Medicare Compliance & QA Associate

Medicare Compliance & QA Associate

Spark Advisors • Lancaster, PA, US
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  • [job_card.full_time]
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Medicare Compliance & Quality Assurance Associate

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 will report to the Medicare Compliance & Quality Assurance Supervisor and partner closely across our Platform, Contracting, Finance, and Sales teams to maintain the highest standards of compliance across our agent network.

Compliance Case Management & Quality Assurance (80%)

  • Manage the complete lifecycle of compliance cases, including intake, investigation, communication, resolution, and formal closure.
  • 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.

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.
  • Assist with preparing reports, summaries, dashboards, or data extracts related to compliance cases, agent performance, 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.
  • Required Experience & Skills

  • Strong organizational skills with the ability to manage multiple tasks and cases accurately and efficiently.
  • Clear and professional written and verbal communication skills for working with agents, carriers, and internal teams.
  • Ability to quickly learn Medicare and compliance concepts and explain them to agents in simple, actionable terms.
  • High attention to detail for documentation, case notes, and recordkeeping.
  • Basic analytical skills to review data, identify simple trends, and support compliance monitoring.
  • Ability to follow structured workflows, processes, and guidelines consistently.
  • Strong judgment, professionalism, and discretion when handling sensitive or confidential information.
  • Nice-to-Have Skills & Experience

  • Prior exposure to Medicare, health insurance, regulatory compliance, customer support, or operations.
  • Familiarity with quality assurance reviews, call evaluations, or enrollment processes (telephonic or field-based).
  • Basic understanding of CMS guidelines, marketing rules, enrollment processes, CTM / complaint handling, or compliance markers such as rapid disenrollments.
  • Experience supporting audits, assessments, or improvement projects through coursework, internships, or previous roles.
  • Comfort learning new systems, dashboards, workflows, or performance metrics.
  • Experience contributing to process improvements, documentation updates, or workflow development.
  • Technical & Process Skills

  • Comfortable using tools such as 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 and quality assurance activities.
  • Ability to learn new technology, systems, and compliance tools quickly.
  • Personal Attributes

  • 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

    Our salary ranges are based on paying competitively for our company's size and industry, and are one part of the total compensation package that also includes equity, benefits, and other opportunities at Spark. In accordance with New York City, Colorado, California, and other applicable laws, Spark is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including qualifications for the role, experience level, skillset, geography, and balancing internal equity. A reasonable estimate of the current salary range is $60,000 - $70,000 USD.

    We also believe that your personal needs and preferences should be taken into consideration, so we allow some choice between equity and cash.

    Why you should join our team

    By joining Spark, you will get in on the ground floor of a fast-moving, well-funded, and mission-driven startup where you will have a profound impact on the brokers and beneficiaries we serve. And you'll learn, grow, be challenged, and have fun with your team while doing it.

    We strive to help you and your family thrive. We're committed to supporting your happiness, healthiness, and overall well-being by providing a comprehensive benefits program. In addition to your base salary, we also offer :

  • Equity compensation
  • Health care, including dental and vision through our PEO Sequoia
  • Flexible work location; co-working available
  • 401k
  • Paid Time Off
  • Monthly Remote Work Stipend (help cover costs of home-office needs)
  • Paid Parental Leave
  • Up to 14 weeks for birthing parents
  • Up to 8 weeks for non-birth parents
  • 11 paid holidays
  • 2 week sabbatical at 5 years of employment
  • Wellbeing Perks through SpringHealth, OneMedical, PerkSpot, and SoFi
  • Compliance

    Spark is a proud participant in E-Verify. As part of our commitment to compliance, we use the E-Verify program to confirm the employment eligibility of all employees working in the United States. For more information about E-Verify, please visit www.e-verify.gov .

    Furthermore, for security and compliance requirements, we're unable to accommodate international remote work. While we fully support travel and time off, all work must be conducted from an approved location within the U.S.

    At Spark, we are committed to hiring the best team to serve our clients regardless of their background. We need diverse perspectives to reflect the diversity of our problems and the population we serve. We look to hire people from a variety of backgrounds, including, but not limited to, race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status.

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