Become a part of our caring community and help us put health first

Humana is seeking a highly motivated Senior Compliance Professional to be part of Humana’s growing Medicaid business. You will be part of the team responsible for oversight of Medicaid Subcontractor compliance with state requirements for Humana’s Medicaid plans. This Senior Compliance Professional will be responsible for ensuring compliance with governmental requirements and will exercise considerable latitude in determining objectives and approaches to assignments. This role will handle work assignments involving moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of various factors.

Key responsibilities:

• Researching compliance issues

• Implementing compliance requirements

• Responding to regulators’ requests applicable to Humana’s oversight of Medicaid Subcontractors.

Responsibilities may also include the following:

• Serving as subject matter expert and point of contact for Subcontractor compliance-related inquiries and requests for assistance

• Researching and applying laws, regulations, and regulatory guidance for federal and state compliance issues applicable to Humana’s Medicaid Subcontractors

• Providing support for internal and external audits and regulators’ requests

• Partnering with Medicaid leaders, law department, other compliance teams, and operational areas on issues relevant to Medicaid Subcontractor compliance

• Managing compliance processes and tools

• Ensuring milestones are achieved, barriers and risks are mitigated, and compliance requirements are met

• Managing communication processes

• Educating Humana associates and Medicaid Subcontractors regarding Medicaid Subcontractor compliance requirements

• Developing policies and procedures

• Providing back-up and support to other team members and performing other duties, as assigned

Use your skills to make an impact

Required Qualifications

• Bachelor’s degree

• 3 years’ experience working in a fast-paced managed care-related or compliance-related field

• Ability to analyze and apply regulatory and contractual requirements

• Strong communication skills

• Strong attention to detail

• Ability to manage multiple or competing priorities and meet deadlines

Preferred Qualifications

• Medicaid experience

• Enterprise Solution Point or Archer Engage experience

• Experience working with regulatory agencies

• Audit or consulting experience

• Knowledge of Humana processes and structure

• JD or MBA

Work-At-Home Requirements

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is required

• Satellite, cellular and microwave connection can be used only if approved by leadership

• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive an email correspondence inviting you to participate in a SMS Text Messaging interview. (please be sure to check your spam or junk folders often to ensure communication isn’t missed) If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 01-20-2025

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.