Remote Policy Governance Analyst – Medicaid UM & Reporting

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

Benefits offered by this job

Bonus eligible

Competitive benefits

Job summary

Humana Inc. seeks a Policy Governance Professional to manage end-to-end Medicaid UM Rates and Timeliness evaluation across applicable markets, coordinating data validation, performance trends, and stakeholder reviews.

You will work with operational, clinical, quality, and compliance teams to ensure accurate reporting and governance alignment. Reporting to the Policy Governance Lead, you will prepare materials for governance bodies, maintain audit-ready documentation, and support policy lifecycle

Qualifications

• Bachelor’s degree
• Experience in healthcare industry (operations, utilization management, quality, compliance, accreditation, reporting, governance, or a related area)
• Proficiency with Microsoft Excel, PowerPoint, Word, SharePoint, and related collaboration or tracking tools

Responsibilities

• Own and coordinate the end-to-end NCQA UM Rates and Timeliness Report process across Medicaid markets.
• Manage reporting calendars, milestones, data collection, validation, approvals, and final deliverables.
• Collaborate with operational, analytical, clinical, quality, compliance, accreditation, and market teams to resolve data issues and report risks.
• Analyze results to identify trends, outliers, performance concerns, and opportunities for improvement.
• Coordinate, document, and monitor corrective or follow-up actions and escalate overdue items as needed.
• Prepare reporting summaries and materials for Utilization Management Committees and leadership review.
• Maintain audit-ready documentation supporting reporting results, decisions, and approvals.

Skills

Healthcare industry experience

Analytical thinking

Education

Bachelor’s degree

Tools

Excel

PowerPoint

Word

SharePoint

Job description

Humana Inc. seeks a Policy Governance Professional to manage end-to-end Medicaid UM Rates and Timeliness evaluation across applicable markets, coordinating data validation, performance trends, and stakeholder reviews.

You will work with operational, clinical, quality, and compliance teams to ensure accurate reporting and governance alignment. Reporting to the Policy Governance Lead, you will prepare materials for governance bodies, maintain audit-ready documentation, and support policy lifecycle