Compliance Professional

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

Humana Healthy Horizons is seeking a Compliance Professional who will ensure compliance with governmental requirements as they relate to Medicaid State reporting. The 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.

• Manages state reporting for assigned Medicaid market(s) (contracts and gathering data for reports).
• Researches compliance issues and recommends changes that assure compliance with contract obligations.
• Maintains relationships with government agencies.
• Coordinates implementation and compliance with corrective action plans as needed.
• Begins to influence department s strategy.
• Makes decisions on moderately complex to complex issues regarding technical approach for project components.

• Must reside in the Eastern or Central time zones within the contiguous United States
• Bachelors degree or equivalent work experience (5+ years of healthcare, insurance, or financial services experience).
• Two (2) or more years of compliance and/or health insurance experience.
• Three (3) or more years of technical and computer navigation experience using multiple systems and platforms, specifically Excel, Word, PowerPoint and other Microsoft Office applications.
• Experience managing multiple or competing priorities and meeting deadlines.

• Analytical experience
• Medicaid state reporting experience
• Experience with ESP
• Graduate degree

• Schedule:
  
  Monday through Friday, 8:00 AM – 5:00 PM with flexibility to work overtime as needed.
• Work Location:
  
  Eastern or Central time zones within the contiguous United States
• Work Style:
  Remote

To Ensure Home Or Hybrid Home/Office Employees’ Ability To Work Effectively, The Self-provided Internet Service Of Home Or Hybrid Home/Office Employees Must Meet The Following Criteria

At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.

Satellite, cellular and microwave connection can be used only if approved by leadership.

Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel:
While this is a remote position, occasional travel to Humana s offices for training or meetings may be required.

40

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.

$65,000 - $88,600 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

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.

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and Center Well healthcare services, we make it easier for the…