Compliance Professional

Humana; United States; Remote; USD 65,000 - 89,000; Full time

Job summary

Humana is seeking a Compliance Professional (Medicaid State Reporting) to ensure regulatory alignment for Medicaid state reporting. The role involves coordinating reports, collaborating with stakeholders, and validating data for accuracy while supporting evolving reporting requirements.

The position is remote within the United States and requires expertise in compliance and MS Office tools. The candidate will work with cross-functional teams to ensure timely submission of state reports and

Qualifications

• Must reside in the eastern or central time zones within the contiguous United States.
• Bachelor's degree or 5+ years healthcare industry, insurance services and/or regulated services.
• 3 plus years compliance or project/process management experience.
• Comprehensive working knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint.

Responsibilities

• Coordinate, prepare, review, and submit required Medicaid state reports in accordance with established requirements and timelines.
• Partner with business owners, market partners, and other stakeholders to obtain information and data needed for state reporting.
• Educate and support business owners and market partners on state reporting processes, requirements, and expectations.
• Review and validate reporting data for completeness and accuracy prior to submission.
• Identify and escalating gaps in data availability that may impact reporting requirements.
• Support the implementation of new and amended state reporting requirements and guidance.
• Maintain reporting documentation and support process improvements to promote consistency, accuracy, and efficiency.

Skills

Compliance experience

Data analysis

Education

Bachelor's degree or 5+ years healthcare/insurance/regulatory experience

Tools

Word

Excel

PowerPoint

Job description

Become a part of our caring community

Humana Healthy Horizons is seeking a Compliance Professional (Medicaid State Reporting) who will ensure compliance with governmental requirements as they relate to Medicaid State reporting. The Compliance Professional's work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Key Responsibilities

• Coordinate, prepare, review, and submit required Medicaid state reports in accordance with established requirements and timelines.
• Partner with business owners, market partners, and other stakeholders to obtain information and data needed for state reporting.
• Educate and support business owners and market partners on state reporting processes, requirements, and expectations.
• Review and validate reporting data for completeness and accuracy prior to submission.
• Identify and escalating gaps in data availability that may impact reporting requirements.
• Support the implementation of new and amended state reporting requirements and guidance.
• Maintain reporting documentation and support process improvements to promote consistency, accuracy, and efficiency.

Use your skills to make an impact

Required Qualifications

• Must reside in the eastern or central time zones within the contiguous United States
• Bachelor's degree or 5+ years of healthcare industry, insurance services and/or regulated services.
• 3 plus years compliance or project/process management experience
• Comprehensive working knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint

Preferred Qualifications

• Medicaid state reporting experience
• Medicaid experience/knowledge
• Prior experience analyzing data and metrics to influence change in departmental processes
• Prior health insurance industry experience
• Experience using Microsoft Copilot

Additional Information

• Location: Remote US - Must reside in the eastern or central time zones within the contiguous United States

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

Work at Home Requirements

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana’s offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$65,000 - $88,600 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline

10-26-2026

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services