Remote Medicare/Medicaid Payment Integrity Analyst

Humana, Inc.; Cheyenne (WY); Remote; USD 65,000 - 89,000; Full time

Job summary

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

The role emphasizes proactive monitoring, reporting, and collaboration across business areas to ensure regulatory and contractual adherence. You will serve as a liaison to CAPI partners, analyze compliance data, and contribute to process improvement and automation opportunities that strengthen oversight and efficiency within

Qualifications

• Minimum of 2 years of experience in compliance or with Medicare and Medicaid federal regulations.
• Experience in Payment Integrity
• Experience managing project-based work
• Intermediate proficiency in Microsoft Word and Excel
• Strong analytical, organizational, and communication skills
• Must be located within the contiguous United States based on Medicare and Medicaid requirements

Responsibilities

• Support Medicare and Medicaid compliance activities related to Payment Integrity, focusing on financial recovery processes.
• Monitor operations to ensure compliance with regulatory, contractual, and internal requirements.
• Identify potential or actual noncompliance issues and coordinate timely mitigation.
• Perform compliance reviews, monitoring, and reporting for accuracy and timeliness.
• Serve as liaison between Compliance and CAPI partners for communication and issue resolution.
• Analyze compliance-related data to identify gaps, risks, and opportunities for improvement.
• Support corrective action planning and remediation with cross-functional teams.
• Maintain documentation and audit-ready materials related to monitoring activities.
• Assist in developing and executing the Payment Integrity Compliance framework.
• Identify and pursue process improvements and automation opportunities for stronger oversight.
• Manage assigned projects and deliverables to align with business priorities.

Skills

Medicare/Medicaid compliance

Payment Integrity

Project management

Excel proficiency

Analytical / communication

US contiguous states resident

Job description

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

The role emphasizes proactive monitoring, reporting, and collaboration across business areas to ensure regulatory and contractual adherence. You will serve as a liaison to CAPI partners, analyze compliance data, and contribute to process improvement and automation opportunities that strengthen oversight and efficiency within