Senior Medicaid Compliance Lead — Remote & Impactful

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

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) retirement savings

Paid time off

Job summary

Humana Inc. is seeking a Senior Compliance Professional for Medicaid to join a fast-growing team dedicated to regulatory excellence. This remote role focuses on developing audit methodologies, monitoring Medicaid operations, and guiding remediation to ensure state and federal compliance.

You will work with Humana operation leaders, analyze regulatory requirements, and support external audits while managing multiple priorities in a dynamic healthcare environment. Some travel may be required.

Qualifications

• Bachelor’s degree in related field with 5+ years in regulatory law, compliance, audit, or risk management.
• Experience in Compliance or managed care.
• Experience with regulatory agencies.
• Ability to analyze regulatory requirements and explain their operational impact.

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 evidence meeting regulatory requirements.
• Interpret and define regulatory and contract requirements for Humana Departments and/or external partners.
• Provide ongoing oversight and monitoring of Medicaid operations to ensure compliance and minimize risk.
• Support external audits and coordinate compliance communications with regulators.
• Provide backup support to Medicaid Regulatory Compliance team members.

Skills

Process improvement

Healthcare regulation

Communication

Attention to detail

Multi-tasking

Regulatory analysis

Education

Bachelor’s degree in related field

Job description

Humana Inc. is seeking a Senior Compliance Professional for Medicaid to join a fast-growing team dedicated to regulatory excellence. This remote role focuses on developing audit methodologies, monitoring Medicaid operations, and guiding remediation to ensure state and federal compliance.

You will work with Humana operation leaders, analyze regulatory requirements, and support external audits while managing multiple priorities in a dynamic healthcare environment. Some travel may be required.