Senior Compliance Professional

Become a part of our caring community and help us put health first
 The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Regulatory Compliance – State Enterprise Intake and Implementation – Senior Compliance Professional

The Senior Compliance Professional implements new statues, regulations, rules and other regulatory guidance issued by state and federal regulators across the enterprise. Coordinates business partner engagement and implementation of rules. Researches compliance issues and recommends changes that ensure compliance with regulatory obligations. Provides compliance guidance and direction to business partners. Monitors metrics and other oversight tools that track implementation activity.  Recommends new measures of compliance performance.  Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding implementation components. Exercises considerable latitude in determining objectives and approaches to assignments.

The Senior Compliance Professional’s primary focus will be to implement new federal and state rules, including PBM, across the enterprise.

Key responsibilities may include:

• Serve as the subject matter expert and point-of-contact for individual state and federal implementations, leading implementation activity from onset to conclusion.
• Research, understand, and apply laws, regulations, and regulatory guidance for federal and state compliance issues.
• Analyze business requirements and complex issues, conduct research, and provide regulatory guidance to business partners, Law, Risk, and Compliance associate and leaders with regard to federal and state implementations.
• Develop and track a caseload of implementations spanning both enterprise-wide and state rules.
• Partner with Law, Risk, Compliance, and other operational partners to ensure an accurate and timely implementation.
• Lead and participate in meetings, providing compliance guidance and direction.
• Provide back-up and support to other Enterprise Compliance team members, and perform other duties, as needed.

 

Use your skills to make an impact
 

Required Qualifications

• Bachelor's degree
• 5 or more years experience in healthcare and/or compliance
• Knowledge/understanding of laws and regulations governed by the Department of Insurance and CMS

Preferred Qualifications

• Graduate or advanced degree
• Experience with regulatory implementations
• Experience with PBM and/or Privacy
• Experience with compliance systems, metrics, and reporting

Additional Information

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: 01-30-2025
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.

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