Compliance Professional

Humana Inc; United States; À distance; USD 65 000 - 89 000; Plein temps

Avantages offerts par ce poste

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Résumé du poste

Humana Inc. is seeking a Compliance Professional (Medicaid State Reporting) to ensure compliance with governmental Medicaid state reporting requirements.

You will coordinate and submit state reports, partner with market leadership, and educate stakeholders on processes to ensure accurate, timely reporting across states. The role involves reviewing data for completeness, identifying gaps, and supporting implementation of new reporting requirements.

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+ years compliance or project/process management experience.
• Comprehensive working knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint.

Responsabilités

• 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 escalate data gaps, reporting issues, or process concerns that may impact timely and accurate reporting.
• 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.

Connaissances

Microsoft Office

Microsoft Copilot

Formation

Bachelor's degree or 5+ years healthcare/regulated services

Description du poste

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. The Compliance Professional will be responsible for coordinating and submitting required state reports for the Medicaid State Reporting team. Reporting to the Compliance Manager, you will partner with market leadership, business owners, and other stakeholders to support accurate and timely state reporting.

Responsibilities may include educating business owners and market partners on state reporting processes, coordinating the collection and validation of required data, and identifying and escalating gaps in data availability that may impact reporting requirements.

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 escalatat[e] data gaps, reporting issues, or process concerns that may impact timely and accurate reporting.
• 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.

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 and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.