Remote Senior Medicaid Compliance Lead

Humana Inc; Richmond (VA); Remote; USD 86,000 - 119,000; Full time

Benefits offered by this job

Medical, dental, and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Disability and life insurance

Job summary

Humana Inc. seeks a Senior Compliance Professional for Medicaid to ensure adherence to state and federal requirements. The role involves leading auditing and monitoring activities, interpreting complex regulatory contracts, and coordinating responses with regulators to minimize enterprise risk.

Ideal candidates have 5+ years in regulatory or risk management within health care, strong communication skills, and the ability to manage multiple priorities in a remote U.S. setting. Travel is limited.

Qualifications

• Bachelor’s degree required; 5+ years in regulatory law, compliance, audit, or risk management.
• Experience in a Compliance- or managed care-related field preferred.
• Experience working with regulatory agencies and interpreting regulatory requirements.

Responsibilities

• Develop audit methodology and perform auditing to prevent and detect noncompliance and guide remedial actions.
• Present findings to business partners and track issues for remediation.
• Oversee development and progress of issue remediation.
• Review documents and data to evidence regulatory compliance requirements.
• Interpret regulatory and contract requirements for Humana Departments and partners.
• Provide ongoing oversight of Medicaid operations to minimize enterprise risk.
• Support external audits and regulatory inquiries.
• Coordinate compliance communication with regulators.

Skills

Regulatory compliance

Audit experience

Healthcare regulations

Regulatory analysis

Communication skills

Education

Bachelor’s degree in related field

Juris Doctor or MBA (preferred)

Job description

Humana Inc. seeks a Senior Compliance Professional for Medicaid to ensure adherence to state and federal requirements. The role involves leading auditing and monitoring activities, interpreting complex regulatory contracts, and coordinating responses with regulators to minimize enterprise risk.

Ideal candidates have 5+ years in regulatory or risk management within health care, strong communication skills, and the ability to manage multiple priorities in a remote U.S. setting. Travel is limited.