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The Associate Director, Compliance ensures compliance with governmental requirements. The Associate Director, Compliance requires a solid understanding of how organization capabilities interrelate across department(s). The Associate Director, Compliance manages dedicated compliance officers who implement compliance programs in support of Medicaid contracts, maintains annual auditing and monitoring work plans, researches compliance issues and recommends changes that assure compliance with contract obligations. Maintains relationships with government agencies. Oversees implementation and compliance with corrective action plans, as needed.

Humana is seeking an Associate Director to oversee compliance programs for Humana’s Medicaid contracts.  The Associate Director oversees compliance associates who are dedicated compliance officers in support of Medicaid state contracts.  The team is responsible for analyzing business requirements, providing research and regulatory interpretation, and advising internal business units and external business partners in delivering results in a manner that minimizes compliance risk exposure for the Company.  Responsible for overseeing completion of risk assessments and annual work plans to audit and monitor performance.  As an Associate Director, you will be part of a fast-growing team who develops and maintains key relationships both internally with Humana operational leaders as well as externally with our business partners. While working within assigned areas to optimize business results, you will:

• Develop strategy and provide on-going oversight and monitoring of Medicaid contracts to ensure full compliance and minimize risk for the Enterprise;
• Oversees compliance team to review and analyze market documents and data to identify what can be used to evidence meeting compliance and regulatory standards;
• Oversee compliance team to audit and monitor performance, and report to leadership top risks, remediation plans and other information as appropriate
• Oversee completion risk assessments and annual work plans to audit and monitor performance. 
• Perform assessments, develop action plans, and provide guidance to internal business units;
• Interpret and define regulatory and contract requirements to be implemented by appropriate Humana Departments and/or external business partners in support of Medicaid;
• Communicate with and present to outside regulators as needed;
• Work across Humana operational units and product lines to enhance data analytics and operational improvement efforts;
• Build relationships with Medicaid market and shared services business units;
• Participate in external audits as needed, working with business partners and other compliance teams.
• Participate in state level and corporate compliance level meetings.
• Report out to leadership status of activities or risk on a monthly

Additional Information:

• This person would report to Director of Regulatory Complianc

Use your skills to make an impact
 

Role Essentials

• Bachelor’s degree
• 5 or more years of experience working in a Compliance-related, risk management and/or managed care-related field
• 2 or more years management and/or leadership experience
• Strong communication skills with the ability to influence effectively
• Experience working with regulatory agencies, including state departments of health insurance and/or CMS
• Knowledgeable in regulations governing health care industries

Role Desirables

• Juris Doctor or Masters of Business Administration
• Experience in Medicaid operations/programs  
• Knowledgeable in process improvement and metrics development
• Knowledgeable in compliance programs and processes 

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 decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$123,800 - $170,400 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