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

Humana Healthy Horizons is seeking a Manager, Compliance - Medicaid State Reporting to ensure compliance with governmental requirements across the organization. This leader will work within specific guidelines and procedures, apply advanced technical knowledge to solve moderately complex problems, and will receive assignments in the form of objectives to determine approach, resources, schedules, and goals.

The Manager, Compliance - Medicaid State Reporting develops and implements compliance policies and procedures, and researches compliance issues as they relate to reporting.

Roles and responsibilities for this position include (not all inclusive):

• Maintains relationships with Market compliance teams.
• Coordinates implementation of new Medicaid markets and compliance with corrective action plans, as needed.
• Recommends changes that assure compliance with contract obligations.
• Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving Medicaid State Reporting.
• Requires cross departmental collaboration and conducts briefings and area meetings.
• Maintains frequent contact with other managers across the department.

Use your skills to make an impact
 

Required Qualifications

• Must reside in the eastern or central time zones within the contiguous United States.
• Bachelor's Degree OR Equivalent Work Experience of 5+ years of healthcare, insurance, and/or financial services experience.
• 2+ years of people or project/process management leadership.
• 5+ years of Compliance, Policy, Risk, and/or Audit experience.
• Prior health insurance industry experience.
• Comprehensive working knowledge of all Microsoft Office applications, including Word, Excel, and PowerPoint.
• Proven experience to manage multiple projects/assignments while working with various departments to obtain data.
• Strong attention to detail and ability to work in a deadline-driven organization.
• Success in developing and managing working relationships within a highly matrixed business environment.

Work at Home Requirements

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Humana will provide Home or Hybrid Home/Office associates 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.

Preferred Qualifications

• Graduate or advanced degree.
• Prior experience analyzing data and metrics to influence change in departmental processes.
• Experience in data visualization tools (Power BI, Tableau, etc.).
• Experience with Enterprise Solution Point (ESP).
• Medicaid experience/knowledge.

Additional Information:

• Workstyle: Remote
• Direct Reports: Up to 10 associates.
• Location: Must reside in the eastern or central times zones in the contiguous United States.
• Core Workdays & Hours: Typically, Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST).
• Benefits: Benefits are effective on day 1. Full time Associates enjoy competitive pay and a comprehensive benefits package that includes 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more.....  

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Hire Vue, a third-party vendor.  This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview.  If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to a