Senior Medicaid Compliance Lead - Remote

Humana Inc; Montpelier (VT); Remote; USD 86,000 - 119,000; Full time

Job summary

Humana Inc. in the United States is seeking a Senior Compliance Professional for Medicaid to join a fast-growing team overseeing regulatory compliance across Medicaid operations.

You will develop audit methodologies, present findings to partners, and coordinate with regulators while ensuring adherence to state and federal laws. This remote role requires strong analytical and communication skills and the ability to manage multiple priorities.

Qualifications

• Bachelor’s degree in related field required.
• 5+ years in regulatory law, compliance, audit, or risk management.
• Experience in compliance-related or managed care field.
• Experience with regulatory agencies.
• Ability to analyze regulatory requirements and impacts on operations.
• Strong written and verbal communication skills.
• Detail-oriented with ability to manage multiple priorities.
• Experience in health plan compliance or operations (preferred).

Responsibilities

• Develop audit methodology and monitor compliance to prevent noncompliance.
• Present findings to business partners and track remediation.
• Oversee progress of issue remediation.
• Review documents and data to evidence regulatory compliance.
• Interpret regulatory and contract requirements for Humana departments.
• Provide ongoing oversight of Medicaid operations to minimize risk.
• Support external audits.
• Coordinate communication with regulators.
• Provide backup to other Medicaid Regulatory Compliance team members.

Skills

Regulatory law

Compliance

Audit

Risk management

Regulatory agencies

Written communication

Attention to detail

Multi-tasking

Independence

Education

Bachelor's degree in related field

Juris Doctor

MBA

Advanced degree

Job description

Humana Inc. in the United States is seeking a Senior Compliance Professional for Medicaid to join a fast-growing team overseeing regulatory compliance across Medicaid operations.

You will develop audit methodologies, present findings to partners, and coordinate with regulators while ensuring adherence to state and federal laws. This remote role requires strong analytical and communication skills and the ability to manage multiple priorities.