Senior Compliance Professional

🕒 2 days 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.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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

• Research and investigate allegations of agent/agency misconduct and assign appropriate corrective action for internal agents • Analyze, identify, and report trends generating agent-related complaints, including CTMs • Take actions to reduce Carrier CTMs and complaints • Identify solutions to systemic compliance problems • Apply Medicare regulations to compliance issues • Respond to interdepartmental inquiries • Coordinate and maintain relationships with carriers, partner agents, and agencies • Make decisions on moderately complex to complex assignment issues with minimal direction • Handle urgent, sensitive work expeditiously • Monitor changes in carrier policies and Medicare regulations and provide insights and recommendations • Collaborate with marketing, operations, and sales teams to integrate compliance into Medicare Advantage initiatives • Prepare and maintain compliance documentation, including reports, training materials, and audit findings • Participate in developing policies and procedures to enhance compliance operations and risk management

🎯 Requirements

• 3+ years of compliance experience within the insurance industry, focused on Medicare Advantage • 1+ years of audit or consulting experience • Experience with metric monitoring and reporting • Strong understanding of Medicare regulations, CMS guidelines, and compliance best practices • Excellent analytical skills for assessing complex regulatory requirements and developing actionable strategies • Strong communication and interpersonal skills for collaborating with stakeholders • Ability to work independently and manage multiple priorities in a fast-paced environment • Bachelor's degree or higher in Business, Finance, Law, Healthcare Administration, or a related field is preferred • Compliance certification such as CHC is preferred • Minimum internet service of 25 Mbps download and 10 Mbps upload for home employees • Wireless, wired cable, or DSL connection suggested; satellite, cellular, and microwave connections require leadership approval • Dedicated, interruption-free workspace to protect member PHI/HIPAA information

🏖️ Benefits

• Bonus incentive plan • 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 • Self-provided internet expense payment for employees who live and work from Home in California, Illinois, Montana, or South Dakota • Humana-provided telephone equipment appropriate to business requirements • Remote work arrangement • Occasional travel to Humana's offices for training or meetings