Compliance & Contract Audit Lead

Description

The Compliance & Contract Audit Lead is responsible for oversight of the Contractor’s risk management process. The position shall analyze operations and critically assess compliance with all requirements.

Responsibilities

Position Responsibilities:

• Coordinates the preparation and execution of Contract documents, audits, and ad hoc visits

• Audits records of Contract agreements in which the organization is involved

• Prepares reports for management on the results of audits, providing recommendations on improvements

• Works with finance to estimate the potential financial consequences of an occurring loss

• Assesses and communicates information regarding business risks with functions across the organization

• Works closely with internal and external auditors, financial investigators, and claims processing areas

• Advises executives to develop functional strategies on matters of significance

• Uses independent judgment requiring analysis of variable factors and determines the best course of action.

               

Required Qualifications

• Bachelor’s degree in related field

• 5+ years’ of experience in auditing, consulting, or compliance-related field

• Experience working with regulatory agencies, including state departments of health insurance or CMS

• Knowledgeable in process improvement and metrics development and in regulations governing healthcare industries

• Strong communication skills

• Must reside in the state of Oklahoma, preferably Oklahoma City metro area

Preferred Qualifications

• Advanced graduate degree

• Certifications, such as: JD, CPA, CIA, CISA, CISSP, or PMP

• 3+ years’ of experience in health plan operations​

• Leadership experience

Additional Information

Our Benefits  

Health benefits effective day 1. Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:  

• Paid time off, holidays, volunteer time and jury duty pay, Recognition pay.  
• 401(k) retirement savings plan with employer match.  
• Tuition assistance, Scholarships for eligible dependents.  
• Parental and caregiver leave.  
• Employee charity matching program.  
• Network Resource Groups (NRGs).  
• Career development opportunities.  

  

Work at Home Criteria  

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 recommended; 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.  

  

Interview Format  

As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.  

Scheduled Weekly Hours

40