Senior Compliance Professional

The Senior Compliance Professional ensures compliance with governmental requirements and focuses on developing and implementing plans to monitor and audit business processes to prevent, detect, and resolve compliance issues related to Humana's Medicaid business partner operations.

Responsibilities:

• Develop audit methodology and perform auditing and monitoring activities to prevent and detect issues of noncompliance
• Present findings of auditing and monitoring efforts to business partners and Enterprise Compliance leaders
• Oversee development and progress of issue remediation
• Review and analyze documents and data to identify what can be used to evidence meeting regulatory requirements
• Interpret and define regulatory and contract requirements to be implemented by appropriate Humana Departments and/or external business partners
• Provide on-going oversight and monitoring of Medicaid business operations to ensure full compliance and minimize risk for the Enterprise
• Provide support in external audits
• Coordinate compliance related communication/interaction with regulators
• Provide backup and support to other Medicaid Regulatory Compliance team members

Requirements:

• Bachelor's degree in a related field
• 5+ years of experience working in regulatory law, compliance, audit, or risk management or managed care-related field
• Experience working with regulatory agencies
• Ability to analyze regulatory requirements and assist business areas with understanding impacts of requirements on their operations

Preferred Qualifications:

• Juris Doctor or Master of Business Administration or advanced degree
• Audit experience
• Experience with metrics and reporting
• Experience in Health Plan Compliance or Health Plan Operations

Benefits:

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• Short-term and long-term disability
• Life insurance