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Humana · 4 days ago

Compliance Professional

United States

Full-time

Remote

Entry, Mid Level

$65K/yr - $89K/yr

2+ years exp

Humana is a health insurance company committed to putting health first. They are seeking a Compliance Professional to support the Medicaid business by overseeing Policy Governance, ensuring that all Medicaid policies are accurate and up-to-date.

Health CareHealth InsuranceInsuranceVenture Capital

Responsibilities

Effectively working with business partners from all levels and all business areas throughout Humana

Performing ad hoc and annual updates to policies and ensuring assigned state-specific reporting is completed timely and accurately

Becoming an expert in using the designated system for ad hoc and annual policy updates, so to be able to perform trainings for business partners on use of the system and answer business partner questions

Approaching Policy Governance with a lens of process improvement of how the team can continue driving efficiency and standardization in policies and procedures

Assisting with drafting and sending policy-related communications to business partners

Escalating to management any policy-related questions or situations, as necessary

Other related activities, as assigned by management

Qualification

Audit ComplianceMedicaid ExperienceProject ManagementPolicy ManagementHealthcare Compliance CertificationRegulatory ExperienceCommunication SkillsOrganizational SkillsRelationship Building

Required

Bachelor's Degree or equivalent work experience

2+ years of project management experience

2+ years of proven experience in an audit, compliance, or regulatory role in a managed care environment

Medicaid experience

Strong written and verbal communication skills; able to effectively communicate in a clear manner

Demonstrated organizational skills, ability to simultaneously work on multiple projects at once, and ability to ensure deliverables are timely and accurate

Demonstrated ability in building and maintaining positive cross-functional relationships and facilitating and consulting across teams

Preferred

Advanced or graduate degree

Policy management experience

Certification such as a Certified Public Accountant, Certified Information Systems Auditor, or Certified Internal Auditor, Project Management certification, Healthcare Compliance Certification, etc

Medicaid health care insurance compliance/regulatory experience

Solid understanding of Humana's operations, technology, communications, processes and interconnectivity between them

Experience interpreting Medicaid contracts

Residing in the Eastern or Central time zones preferred