Compliance Professional, Medicaid Managed Care

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $65k - $88.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚔 Compliance

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Support overall Medicaid business efforts through Policy Governance • Coordinate ad hoc and annual updates to Medicaid policies across business units and states • Ensure Medicaid policy content is accurate, up-to-date, and reviewed annually • Collaborate with business partners to facilitate policy updates • Perform ad hoc and annual policy updates • Complete assigned state-specific reporting accurately and on time • Become an expert in the designated policy maintenance system • Train business partners on use of the designated system • Answer business partner questions about the policy maintenance system • Drive process improvement, efficiency, and standardization in policies and procedures • Assist with drafting and sending policy-related communications • Escalate policy-related questions or situations to management as necessary • Perform other related activities as assigned by management

🎯 Requirements

• Bachelor's degree or 2 years of equivalent professional experience • 2+ years of project management experience • 2+ years of experience in an audit, compliance, or regulatory role within a managed care environment • Medicaid experience • Written and verbal communication skills with the ability to communicate information clearly and effectively • Organizational skills, including the ability to manage multiple projects simultaneously and ensure timely, accurate deliverables • Ability to build and maintain positive cross-functional relationships and facilitate collaboration and consultation across teams • Residence within the Eastern or Central time zones is preferred • Work Monday through Friday, 8:00 AM–5:00 PM Eastern Time, regardless of residence • Minimum home internet speed of 25 Mbps download and 10 Mbps upload • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Fully remote, work from home position • Minimal travel; occasional internal team meetings and travel to Humana offices may be required • Self-provided internet service requirements for home work • Dedicated workspace to protect member PHI/HIPAA information