Remote Medicare Compliance & Payment Integrity Analyst

Humana Inc; United States; Remote; USD 65.000 - 89.000; Vollzeit

Zusammenfassung

Humana Inc. is seeking a Compliance Professional 2 to support Medicare and Medicaid compliance with a focus on Payment Integrity financial recovery processes.

This role serves as a liaison across business areas to promote clear communication, effective oversight, and operational consistency in compliance monitoring and reporting. Remote in the contiguous United States, this position requires strong attention to detail, timely execution, and sound judgment, with opportunities to drive process

Qualifikationen

• Minimum of 2 years of compliance exposure or Medicare/Medicaid regulation experience.
• Payment Integrity experience required.
• Experience managing project-based work.
• Proficient in Microsoft Word and Excel.
• Strong analytical, organizational, and communication skills.
• Location within the contiguous United States.

Aufgaben

• Support Medicare and Medicaid compliance activities related to Payment Integrity, with a primary focus on financial recovery processes.
• Monitor operations to ensure compliance with regulatory, contractual, and internal requirements.
• Proactively identify potential or actual incidents of noncompliance and coordinate timely mitigation and follow-up activities.
• Perform compliance reviews, monitoring, and reporting to help ensure accuracy, timeliness, and operational consistency.
• Serve as a liaison between Compliance and CAPI business partners to support effective communication, issue resolution, and adherence to requirements.
• Analyze compliance-related data, trends, and process outcomes to identify gaps, risks, and opportunities for improvement.
• Support corrective action planning and remediation efforts in partnership with cross-functional teams.
• Maintain documentation, reporting, and audit-ready support materials related to compliance monitoring activities.
• Assist in the development, enhancement, and ongoing execution of the Payment Integrity Compliance framework.
• Identify and support process improvement and automation opportunities that strengthen compliance oversight and operational efficiency.
• Manage assigned projects and deliverables, ensuring work is completed accurately, timely, and in alignment with business priorities.
• Provide team support and coverage, as needed, to help maintain continuity of compliance monitoring and financial recovery operations.

Kenntnisse

Payment Integrity

Compliance experience

Project management

Analytical skills

Communication skills

Tools

Microsoft Word

Microsoft Excel

Jobbeschreibung

Humana Inc. is seeking a Compliance Professional 2 to support Medicare and Medicaid compliance with a focus on Payment Integrity financial recovery processes.

This role serves as a liaison across business areas to promote clear communication, effective oversight, and operational consistency in compliance monitoring and reporting. Remote in the contiguous United States, this position requires strong attention to detail, timely execution, and sound judgment, with opportunities to drive process