Remote Program Integrity Lead - Contracts & Compliance

Humana Inc; Cheyenne (WY); Remote; USD 95,000 - 131,000; Full time

Job summary

Humana Inc. is seeking a PI Contract Lead to join the remote Program Integrity leadership team in the United States. The role requires expertise in federal healthcare programs, regulatory compliance, and contract management.

You will analyze processes, develop improvements, and provide consultative support to stakeholders to ensure compliance and effective contract performance. The position emphasizes leading cross-functional initiatives, performing root-cause analyses, and implementing

Qualifications

• 5+ years of Program Integrity and/or Payment Integrity experience.

Responsibilities

• Translate contract requirements into actionable business processes and workflows.
• Identify operational gaps and propose changes to meet contractual requirements.
• Establish a contract monitoring framework and track SLAs, KPIs, and deliverables.
• Apply Lean, Six Sigma, and root cause analysis to improve operations.
• Conduct routine reviews to ensure alignment with contractual obligations.

Skills

PI experience

Project management

Communication

Education

RN/BSN

CPC

CCS

CCDS

CHC

HCAFA

AHFI

CFE

JD

Tools

Microsoft Office

Excel

PowerPoint

Word

Job description

Humana Inc. is seeking a PI Contract Lead to join the remote Program Integrity leadership team in the United States. The role requires expertise in federal healthcare programs, regulatory compliance, and contract management.

You will analyze processes, develop improvements, and provide consultative support to stakeholders to ensure compliance and effective contract performance. The position emphasizes leading cross-functional initiatives, performing root-cause analyses, and implementing