Remote Program Integrity Contract Lead

Humana Inc

Lansing (MI)

Remote

USD 95,000 - 131,000

Full time

4 days ago

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Benefits offered by this job

Medical, dental and vision benefits

401(k) retirement savings

Paid time off incl. holidays

Job summary

Humana Inc. seeks a Program Integrity Contract Lead to drive compliance with CCN, FAR and federal/state laws. You will translate contract requirements into actionable processes and lead cross-functional improvements, applying Lean/Six Sigma and root-cause analysis.

Remote work is supported with periodic travel to Humana offices as needed. You will collaborate with Compliance and Leadership to implement corrective actions, monitor performance, and develop data-driven strategies for risk

Qualifications

5+ years in Program Integrity/Payment Integrity.
2+ years in project management, ideally for large contracts.
One of listed anti-fraud degrees/certifications is required.

Responsibilities

Translate contract requirements into processes, workflows, controls and operational requirements.
Identify gaps and propose changes to meet contractual requirements.
Establish and maintain a contract monitoring framework for compliance.
Apply Lean, Six Sigma and root-cause analysis to improve performance.
Conduct routine reviews to ensure ongoing alignment with obligations.
Provide consultative support and training to stakeholders.