Senior Compliance Professional, Medicaid

🔥 12 hours ago

🇺🇸 United States – Remote

💵 $86.3k - $118.7k / year

⏰ Full Time

🟠 Senior

🚔 Compliance

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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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

• Develop audit methodology and perform auditing and monitoring activities to prevent and detect noncompliance • Provide guidance on remedial actions to strengthen compliance controls and ensure compliance with state and federal laws and regulations • Present audit and monitoring findings to business partners and Enterprise Compliance leaders • Track issues to ensure appropriate and timely remediation • Oversee development and progress of issue remediation • Review and analyze documents and data to evidence compliance with regulatory requirements • Interpret and define regulatory and contract requirements for implementation by Humana departments and external business partners • Provide ongoing oversight and monitoring of Medicaid business operations • Support external audits • Coordinate compliance-related communication and interaction with regulators • Provide backup and support to other Medicaid Regulatory Compliance team members • Perform other duties as needed • Serve as an individual contributor

🎯 Requirements

• Bachelor’s degree in related field • 5+ years of experience working in regulatory law, compliance, audit, or risk management field • Experience working in a Compliance-related or managed care-related field • Experience working with regulatory agencies • Ability to analyze regulatory requirements and assist business areas with understanding impacts of requirements on their operations • Knowledge of process improvement • Knowledge of regulations governing health care industries • Strong written and verbal communication skills • Strong attention to detail • Ability to manage multiple or competing priorities and meet deadlines • Ability to perform work assignments without direction and exercise considerable latitude in determining objectives and approaches • Fully remote within the U.S. • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information • Home internet with at least 25 Mbps download and 10 Mbps upload speeds

🏖️ 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 • Limited travel based on business needs