Medicaid Compliance Lead (Remote)

Humana, Inc.; Stati Uniti; Remoto; USD 86.000 - 119.000; Tempo pieno

Descrizione del lavoro

Humana, Inc. is seeking a Senior Compliance Professional to join our Medicaid compliance team.

This fully remote nationwide role focuses on ensuring adherence to state and federal requirements and on minimizing regulatory risk across Humana’s Medicaid partner operations. You will develop audit plans, monitor processes, review documents, and coordinate with regulators and internal partners to remediate issues and strengthen controls.

Competenze

• Bachelor’s degree in related field
• 5+ years in regulatory law, compliance, audit, or risk management or managed care-related field
• Experience working with regulatory agencies
• Ability to analyze regulatory requirements and assist business areas with understanding impacts

Mansioni

• 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

Conoscenze

Process improvement

Regulatory knowledge

Written communication

Verbal communication

Attention to detail

Time management

Formazione

Bachelor’s degree in related field

Descrizione del lavoro

Humana, Inc. is seeking a Senior Compliance Professional to join our Medicaid compliance team.

This fully remote nationwide role focuses on ensuring adherence to state and federal requirements and on minimizing regulatory risk across Humana’s Medicaid partner operations. You will develop audit plans, monitor processes, review documents, and coordinate with regulators and internal partners to remediate issues and strengthen controls.