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 implementing new Medicaid markets for the Medicaid State Reporting team. This professional will be a key business partner to market leadership and will be seen as a reporting advisor during implementation efforts, 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 Equivalent Work Experience of 5+ years 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.

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 Medicaid health insurance industry experience.
• PMP
• 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:

• Workstyle: Remote
• 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