Senior Compliance Professional

Humana; Louisville (KY); Hybrid; USD 86,000 - 119,000; Full time

Benefits offered by this job

Remote work at home

Job summary

Humana is seeking a Senior Compliance Professional to ensure adherence to governmental requirements and contract obligations. The role involves solving moderately to highly complex regulatory issues and developing robust compliance policies.

Ideal candidates have at least 5 years in healthcare compliance, strong MS Office skills, and experience with DoI and CMS regulations. Remote work is supported, with in-office presence at least one day per month in Louisville, KY.

Qualifications

• Bachelor's degree required or equivalent.
• Minimum 5 years' healthcare compliance experience with cross-functional collaboration.
• Knowledge of laws and regulations governed by the Department of Insurance and CMS.
• Audit, consolidation and compliance experience.
• Proficient with MS Office; ability to apply laws and contracts to business solutions.
• Experience communicating complex regulatory issues clearly.

Responsibilities

• Ensure compliance with governmental requirements and regulatory obligations.
• Develop and implement compliance policies and procedures.
• Research compliance issues and recommend changes to meet contract obligations.
• Maintain relationships with government agencies and coordinate regulator site visits.
• Lead calls and drive discussions; influence department strategy.
• Occasional office presence required; travel as needed.

Skills

Healthcare compliance

Cross-functional collaboration

Regulatory knowledge

Contract compliance

Documentation & reporting

Communication skills

Education

Bachelor's degree

Tools

MS Office Suite

Job description

Become a part of our caring community

The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Become a part of our caring community

The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Compliance Professional ensures compliance with legal, contractual, statutory and regulatory requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Compliance Professional develops and implements compliance policies and procedures. Research compliance issues and recommend changes that ensure compliance with contract obligations. Maintain relationships with government agencies. Coordinate site visits for regulators, coordinates implementation and compliance with corrective action plans. Begin to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and performs work without direction. Exercise considerable latitude in determining objectives and approaches to assignments. Is accountable for accurate, timely and complete deliverables associated with contractual and regulatory requirements. Exercise due diligence in reviewing documentation and communicates complex issues clearly and logically, both verbally and in writing. Demonstrate leadership with integrity and a willingness to accept responsibility and implement process improvements whenever possible. Build relationships with internal and external partners through consistency, reliability, willingness to assist and support and sharing in a "same team" mentality. Must participate on camera for meetings and is expected to actively participate and collaborate, and where appropriate, lead calls, drive discussions, ask critical questions, and recommend strategies and solutions. Although this is a remote position, the associate in this position will be expected to work in the office no less than one day per month and as needed for training and other meetings.

Required Qualifications

Use your skills to make an impact

• Bachelor's degree
• Minimum 5 years' experience in healthcare compliance and cross functional collaboration
• Knowledge of laws and regulations governed by the Department of Insurance and CMS
• Audit, consolidating, compliance experience
• Intermediate or Advanced MS Office Suite, (Word, Excel)
• Experience applying laws, regulations, and contracts to achieve day to day business solutions.

Preferred Qualifications

• J.D. preferred; graduate or advanced degree
• Experience with metrics and reporting
• Experience communicating with state regulatory agencies

Additional Information

Workstyle: Remote Work at Home

Location: Louisville, KY or surrounding states

Schedule: Monday through Friday 8-5 Eastern

Travel: about 1 time monthly or as business needs

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours 40

Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $86,300 - $118,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description Of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.