Senior Medicaid Compliance Leader (Remote)

Humana; Frankfort (KY); Remote; USD 86,000 - 119,000; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

Humana is seeking a Senior Compliance Professional for Medicaid to ensure regulatory alignment across state and federal requirements. The role handles moderately complex to complex issues with in-depth data analysis and cross-functional collaboration.

You will develop audit methodologies, oversee remediation, and coordinate with regulators, business partners, and internal teams to maintain compliant Medicaid operations while supporting external audits. Remote within the U.S.

Qualifications

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

Responsibilities

• Develop audit methodology and perform auditing and monitoring activities to prevent and detect noncompliance and provide guidance on remedial actions.
• 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 regulatory compliance.
• Interpret regulatory and contract requirements for Humana Departments or external partners.
• Provide ongoing oversight and monitoring of Medicaid operations to minimize risk.
• Support external audits.
• Coordinate compliance communication with regulators.
• Provide backup to Medicaid Regulatory Compliance team.

Skills

Process improvement

Healthcare regulations

Communication skills

Attention to detail

Multitasking

Independent work

Education

Bachelor's degree

Juris Doctor

MBA

Job description

Humana is seeking a Senior Compliance Professional for Medicaid to ensure regulatory alignment across state and federal requirements. The role handles moderately complex to complex issues with in-depth data analysis and cross-functional collaboration.

You will develop audit methodologies, oversee remediation, and coordinate with regulators, business partners, and internal teams to maintain compliant Medicaid operations while supporting external audits. Remote within the U.S.