Medicaid Compliance Lead — Remote

Humana Inc; Cheyenne (WY); Remote; USD 71,000 - 119,000; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

Humana Inc. is seeking a Senior Compliance Professional for Medicaid to lead regulatory compliance efforts across state and federal requirements. This role focuses on auditing, issue remediation, and ongoing oversight to minimize enterprise risk while partnering with operational leaders.

The ideal candidate will have 5+ years in regulatory law, compliance, or risk management, with strong communication skills, and a background in health plan compliance or managed care. This is a remote U.S.

Qualifications

• 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.

Responsibilities

• Develop audit methodology and perform auditing and monitoring activities to prevent and detect issues of noncompliance and provide guidance on remedial actions to strengthen compliance controls and ensure compliance with state and federal laws and regulations.
• Present findings of auditing and monitoring efforts to business partners and Enterprise Compliance leaders and track issues to ensure appropriate and timely remediation.
• Oversee development and progress of issue remediation.
• Review and analyze documents and data to identify what can be used to evidence meeting regulatory requirements.
• Interpret and define regulatory and contract requirements to be implemented by appropriate Humana Departments and/or external business partners.
• Provide on-going oversight and monitoring of Medicaid business operations to ensure full compliance and minimize risk for the Enterprise.
• Provide support in external audits.
• Coordinate compliance related communication/interaction with regulators.
• Provide backup and support to other Medicaid Regulatory Compliance team members and perform other duties, as needed.

Skills

Strong written and verbalcommunication

Attention to detail

Multi-tasking

Education

Bachelor’s degree in related field

Juris Doctor or MBA or advanced degree

Job description

Humana Inc. is seeking a Senior Compliance Professional for Medicaid to lead regulatory compliance efforts across state and federal requirements. This role focuses on auditing, issue remediation, and ongoing oversight to minimize enterprise risk while partnering with operational leaders.

The ideal candidate will have 5+ years in regulatory law, compliance, or risk management, with strong communication skills, and a background in health plan compliance or managed care. This is a remote U.S.