Senior Compliance Professional
HumanaAbout the role
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.Humana Military, a wholly owned subsidiary of Humana Inc., partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their families in the East Region, comprised of 24 states plus the District of Columbia, 500K providers and approximately 2M beneficiaries.
The Senior Compliance Professional is a Humana Military associate who is responsible for managing compliance in support of TRICARE optimization product lines encompassing clinical and network enhancement. Responsible for ensuring our company, contractors, and vendors adhere to relevant laws, regulations, and internal policies in support of TRICARE optimization programs. A detail-oriented individual responsible for ensuring compliance with governmental requirements, as well as developing and implementing compliance policies and procedures. Researches compliance issues and recommends changes that assure compliance with contract obligations. Maintains relationships with internal departments and government entities. Coordinates site visits. Coordinates implementation and compliance with corrective action plans, as needed. Requires the ability to manage multiple priorities of business partners in a complex, multi-business segment environment; to assimilate, analyze, draw conclusions, and make recommendations from multi-faceted, often ambiguous, information; to motivate project team members and stakeholders to meet established deadlines; to be flexible and willing to learn new skill sets quickly as needs arise.
Use your skills to make an impact
Required Qualifications
Our Department of Defense contract requires U.S. Citizenship
Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services)
5 years of experience with compliance activities
Experience with metrics and reporting
Experience in the Military Health System/TRICARE or with other government agencies
Preferred Qualifications
Bachelor's degree
3 or more years in healthcare
Knowledge of healthcare contracting
Knowledge of preparing for and executing audit requirements
Additional Information
Work style
Hybrid office - will be working out of the HGB Clocktower building in Louisville, KY 2 - 3 days a week, and the rest from home.
Work at Home/Remote Requirements
WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense
A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Scheduled Weekly Hours
40Pay 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.
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.
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 healthcaApply for this role
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