Senior Compliance Professional - Specialty Dental and Vision jobs in United States
cer-icon
Apply on Employer Site
company-logo

Humana · 22 hours ago

Senior Compliance Professional - Specialty Dental and Vision

Humana Inc. is committed to putting health first and is seeking a Senior Compliance Professional to ensure compliance with governmental requirements related to Specialty Dental and Vision plans. This role involves analyzing business requirements, providing regulatory guidance, and developing compliance policies to minimize risk exposure for the company.

Health CareHealth InsuranceInsuranceVenture Capital

Responsibilities

Research, understand and apply laws, regulations, and regulatory guidance for compliance issues with a focus on Dental and Vision plans
Complete risk assessments, 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 and ensure compliance with state and federal laws and regulations
Analyze business requirements and complex issues, conduct research, and provide regulatory guidance to business partners, Law, and Enterprise Compliance associates and leaders with regard to compliance issues
Develop and track compliance metrics and other oversight tools and data analytics to help monitor and detect potential compliance issues
Present findings of monitoring and auditing efforts to business partners and Enterprise Compliance leaders and track issue to ensure appropriate and timely remediation
Review and analyze documents and data to identify what can be used to evidence meeting regulatory requirements
Assist in document review and mock audits in preparation for external audits
Coordinate compliance related communication/interaction with regulators as needed and in response to external audit and exam submissions
Provide back-up and support to other Enterprise Compliance team members and perform other duties, as needed

Qualification

Regulatory complianceAudit methodologyRisk managementCMS-regulated plansDentalVision plansData analysisJuris DoctorMaster of Business AdministrationSoft skills

Required

Bachelor's degree in related field
2 to 5+ years' experience working in regulatory law, compliance, audit, risk management or health plan operations field
Ability to analyze regulatory requirements and assist business areas with understanding impacts of requirements on their operations
Experience/Knowledge of CMS-regulated plans
Ability to manage multiple or competing priorities and meet deadlines

Preferred

Juris Doctor or Master of Business Administration or advanced degree
Experience/Knowledge of Dental and Vision plans
Direct audit experience (state or federal)

Benefits

Medical, dental and vision benefits
401(k) retirement savings plan
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 is a health insurance provider for individuals, families, and businesses.

Funding

Current Stage
Public Company
Total Funding
$13.07B
2025-05-30Post Ipo Debt· $5B
2025-03-03Post Ipo Debt· $1.25B
2024-03-11Post Ipo Debt· $2.25B

Leadership Team

leader-logo
Jim Rechtin
CEO and President
linkedin
leader-logo
Caleb Gallifant
Chief Operating Officer, CenterWell Home Health
linkedin
Company data provided by crunchbase