Humana · 7 hours ago
Payment Integrity Professional 2
United States
Full-time
Remote
Mid Level
$65K/yr - $89K/yrHumana is committed to putting health first and is seeking a Payment Integrity Professional 2 for the Special Investigations Unit (SIU) Medicaid Team. This role focuses on ensuring compliance with reporting requirements across Medicaid Lines of Business, leading a team in program integrity reporting, and analyzing data for insights.
Health CareHealth InsuranceInsuranceVenture Capital
Responsibilities
Lead a team focused on Medicaid program integrity reporting for SIU
Research and suggest process improvements
Collect, analyze, and interpret data for regular and ad hoc reporting
Respond to SIU leadership’s requests for data and insights
Keep communication flowing between the Resolution Team – Compliance Research & Reporting and SIU teams
Use reporting tools and software (Excel, PowerPoint, etc.) to present findings
SME for the implementation of required reporting related to SIU
Qualification
Required
Experience in compliance reporting, Medicaid reporting, and/or SIU support
Claims experience
Good attention to detail, especially for contracts and reports
Proficient with Microsoft Office (Excel, Word, PowerPoint)
Ability to juggle multiple priorities and meet deadlines
Strong communication and teamwork skills
Can work independently and determine appropriate courses of action
Capacity to maintain confidentiality
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred
Bachelor's or advanced degree
Audit, consulting, and/or compliance background
Knowledge of Department of Insurance, CMS, and Medicaid contracts
Experience with healthcare fraud investigations or SIU work
Familiarity with Power BI and SQL
Benefits
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
Company
Humana
Humana is a health insurance provider for individuals, families, and businesses.
Founded in 1964
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$13.07B2025-05-30Post Ipo Debt· $5B
2025-03-03Post Ipo Debt· $1.25B
2024-03-11Post Ipo Debt· $2.25B
Leadership Team
Jim Rechtin
CEO and President
Caleb Gallifant
Chief Operating Officer, CenterWell Home Health
Recent News
2026-01-16
2026-01-16
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