Senior Compliance Professional - Medicaid

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

Healthcare isn’t just about health anymore. It’s about caring for family, friends, finances, and personal life goals. It’s about living life fully. At Humana, we want to help people everywhere, including our associates, lead their best lives. We support our associates to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our associates fresh perspective, new insights, and exciting opportunities to grow their careers. At Humana, we’re seeking innovative people who want to make positive changes in their lives, the lives of our members, and the healthcare industry as a whole.

Description

The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional’s work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Senior Compliance Professional will analyze business requirements, provide research and regulatory interpretation, and advise internal business units and external business partners in delivering results in a manner that minimizes compliance risk exposure for the Company. The Senior Compliance Professional’s primary focus to support implementation of new Medicaid contracts including serving as an interim compliance officer if needed.

Responsibilities

As a Senior Compliance Professional for our Medicaid business, you will be part of a fast-growing team who develops and maintains key relationships with Humana operational leaders. While working within assigned areas to optimize business results, you will:

• Support implementation of new Medicaid contracts end to end, which could include serving as interim compliance officer and other duties as assigned

• Interpret and define regulatory and contract requirements to be implemented by appropriate Humana Departments and/or external business partners; 
• Review and analyze documents and data to identify what can be used to evidence meeting regulatory requirements
• Provide support through entire end to end readiness and go live process
• Assist in document review and mock audits in preparation for external audits;
• Coordinate compliance related communication/interaction with regulators;
• Oversee development and progress of issue remediation;
• Other projects as assigned by Regulatory Compliance Leadership.

Use your skills to make an impact
 

Required Qualifications

• Bachelor’s degree in related field
• Experience working in regulatory law, compliance, audit, or risk management field
• 2-3 years of experience in Medicaid managed- care
• 1-2 years of experience with Medicaid Managed Care Procurement processes
• Ability to analyze regulatory requirements and assist business areas with understanding impacts of requirements on their operations
• Knowledgeable in regulations governing health care industries
• Ability to manage multiple or competing priorities and meet deadlines

Preferred Qualifications

• Juris Doctor or Master of Business Administration or advanced degree
• Experience in Health Plan Compliance or Health Plan Operations

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: 04-29-2025

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.