97 applicants

Company

Humana · 22 hours ago

Associate Director, Compliance

Remote Nationwide

Full-time

Remote

Senior Level, Lead/Staff

$124K/yr - $170K/yr

5+ years exp

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H1B Sponsor Likely

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Responsibilities

Develop strategy and provide on-going oversight and monitoring of Medicaid contracts to ensure full compliance and minimize risk for the Enterprise;

Oversees compliance team to review and analyze market documents and data to identify what can be used to evidence meeting compliance and regulatory standards;

Oversee compliance team to audit and monitor performance, and report to leadership top risks, remediation plans and other information as appropriate

Oversee completion risk assessments and annual work plans to audit and monitor performance.

Perform assessments, develop action plans, and provide guidance to internal business units;

Interpret and define regulatory and contract requirements to be implemented by appropriate Humana Departments and/or external business partners in support of Medicaid;

Communicate with and present to outside regulators as needed;

Work across Humana operational units and product lines to enhance data analytics and operational improvement efforts;

Build relationships with Medicaid market and shared services business units;

Participate in external audits as needed, working with business partners and other compliance teams.

Participate in state level and corporate compliance level meetings.

Report out to leadership status of activities or risk on a monthly

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

ComplianceRisk ManagementManaged CareRegulatory Agencies InteractionHealth Care RegulationsMedicaid OperationsLeadership ExperienceProcess ImprovementCompliance Programs Knowledge

Required

Bachelor’s degree

5 or more years of experience working in a Compliance-related, risk management and/or managed care-related field

2 or more years management and/or leadership experience

Strong communication skills with the ability to influence effectively

Experience working with regulatory agencies, including state departments of health insurance and/or CMS

Knowledgeable in regulations governing health care industries

Preferred

Juris Doctor or Masters of Business Administration

Experience in Medicaid operations/programs

Knowledgeable in process improvement and metrics development

Knowledgeable in compliance programs and processes

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

Glassdoor

3.8

Humana is a health insurance provider for individuals, families, and businesses.

Founded in 1964

Louisville, Kentucky, USA

10,001+ employees

http://www.humana.com

H1B Sponsorship

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Trends of Total Sponsorships

2023 (217)

2022 (257)

2021 (258)

2020 (107)