Senior Medicaid Compliance Lead (Remote)

Humana Inc; Helena (MT); Remote; USD 86,000 - 119,000; Full time

Job summary

Humana Inc. seeks a Senior Compliance Professional for Medicaid to ensure compliance with state and federal laws. You will develop audit methodologies, conduct auditing activities, and guide remediation efforts across regulatory requirements.

You will partner with Humana operational leaders, oversee issue remediation, and support external audits. The role is fully remote within the U.S., with travel as needed, and offers a competitive benefits package including time off and healthcare options.

Qualifications

• Bachelor’s degree in related field required.
• 5+ years of experience in regulatory law, compliance, audit, or risk management.
• Experience in a compliance- or managed care-related field.
• Experience working with regulatory agencies.
• Ability to analyze regulatory requirements and assist business areas with understanding impacts on operations.

Responsibilities

• Develop audit methodology and perform auditing and monitoring activities to prevent and detect issues of noncompliance and provide guidance on remedial actions to strengthen compliance controls.
• Present findings of auditing and monitoring efforts to business partners and Enterprise Compliance leaders and track issues to ensure remediation.
• Oversee development and progress of issue remediation.
• Review and analyze documents and data to identify evidence of meeting regulatory requirements.
• Interpret and define regulatory and contract requirements to be implemented by Humana Departments or external partners.
• Provide ongoing oversight and monitoring of Medicaid operations to ensure compliance and minimize risk.
• Provide support in external audits.
• Coordinate compliance-related communication with regulators.
• Provide backup and support to other Medicaid Regulatory Compliance team members.

Skills

Regulatory compliance

Auditing

Communication skills

Attention to detail

Project management

Education

Bachelor’s degree in related field

Juris Doctor or MBA

Job description

Humana Inc. seeks a Senior Compliance Professional for Medicaid to ensure compliance with state and federal laws. You will develop audit methodologies, conduct auditing activities, and guide remediation efforts across regulatory requirements.

You will partner with Humana operational leaders, oversee issue remediation, and support external audits. The role is fully remote within the U.S., with travel as needed, and offers a competitive benefits package including time off and healthcare options.