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

Humana Healthy Horizons is seeking a Senior Compliance Professional to ensure compliance as they relate to Medicaid State reporting. 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.

The Senior Compliance Professional (Medicaid State Reporting) will be responsible for submitting required state reports for the Medicaid State Reporting team (IN). This professional will be a key business partner to market leadership and will be seen as a reporting advisor during implementation efforts for the new integrated plan in the state, which may include educating business owners and market partners on state reporting processes and identifying/remediating gaps in data availability to meet reporting requirements.

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

• Manages state reporting for assigned Medicaid market(s) (contracts and gathering data for reports)
• Researches compliance issues and recommends changes that assure compliance with contract obligations
• Maintains relationships with government agencies
• Coordinates implementation and compliance with corrective action plans, as needed
• Begins to influence department’s strategy
• Makes decisions on moderately complex to complex issues regarding technical approach for project components

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 5+ Years of Equivalent Work Experience of healthcare, insurance, and/or financial services experience
• 3+ years of Compliance, Policy, Risk, and/or Audit experience
• Comprehensive working knowledge of all Microsoft Office applications, including Word, Excel, and PowerPoint
• Proven experience collaborating with various departments to build, collect, validate, and communicate large sets of 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

Preferred Qualifications

• Graduate or advanced degree
• Prior Medicaid health insurance industry experience
• 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)

Additional Information

WAH Internet Statement

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 required; 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.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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 vis