Compliance Professional

** Become a part of our caring community and help us put health first*
* Humana Healthy Horizons is hiring a Compliance Professional who will support efforts for overall Medicaid business by joining the team overseeing the facilitation of Policy Governance. The Policy Governance team coordinates ad hoc as well as annual updates to all Medicaid policies across business units and across states. This core function is crucial to Humana ensuring that all Medicaid policies are accurate, up-to-date and reviewed annually, at a minimum.

This is a fully remote, work from home position.

The Policy Governance Compliance Professional works to ensure accurate and updated policy content for Medicaid.  The Compliance Professional will work collaboratively with business partners to facilitate policy updates throughout the year as well as during annual review.  This position requires strong technical skills to leverage the designated system for policy maintenance, as well as strong relationship skills in working collaboratively with business partners.

** Key responsibilities for this role include:*
* + Effectively working with business partners from all levels and all business areas throughout Humana.

+ Performing ad hoc and annual updates to policies and ensuring assigned state-specific reporting is completed timely and accurately.

+ Becoming an expert in using the designated system for ad hoc and annual policy updates, so to be able to perform trainings for business partners on use of the system and answer business partner questions.

+ Approaching Policy Governance with a lens of process improvement of how the team can continue driving efficiency and standardization in policies and procedures.

+ Assisting with drafting and sending policy-related communications to business partners.

+ Escalating to management any policy-related questions or situations, as necessary.

+ Other related activities, as assigned by management.

** Use your skills to make an impact*
* ** Required Qualifications*
* + Bachelor's Degree or equivalent work experience.

+ 2+ years of project management experience.

+ 2+ years of proven experience in an audit, compliance, or regulatory role in a managed care environment.

+ Medicaid experience.

+ Strong written and verbal communication skills; able to effectively communicate in a clear manner.

+ Demonstrated organizational skills, ability to simultaneously work on multiple projects at once, and ability to ensure deliverables are timely and accurate.

+ Demonstrated ability in building and maintaining positive cross-functional relationships and facilitating and consulting across teams.

** Preferred Qualifications*
* + Advanced or graduate degree.

+ Policy management experience.

+ Certification such as a Certified Public Accountant, Certified Information Systems Auditor, or Certified Internal Auditor, Project Management certification, Healthcare Compliance Certification, etc.

+ Medicaid health care insurance compliance/regulatory experience.

+ Solid understanding of Humana's operations, technology, communications, processes and interconnectivity between them.

+ Experience interpreting Medicaid contracts.

+ Residing in the Eastern or Central time zones preferred.

** Work at Home Requirements*
* 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 required.

+ 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.

** Additional information*
* +  
** Workstyle:
** Remote, work at home.

+  
** Core workdays and hours:
** Monday through Friday, 8:00 am-5:00 pm in the Eastern Standard Time (EST) regardless of where you reside.

** Interview Format*
* As part of our hiring process for this opportunity, we will be using an interviewing technology called Hire Vue to enhance our hiring and decision-making ability. Hire Vue 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.

** Alert:  Humana values personal identity protection.  Please be aware that applicants selected for leader review may be
** asked to provide a social security number, if it is not already on file.  When required, an email will be sent from  with instructions to add the information into the application at Humana's secure website.

Travel:
While this is a remote position, occasional…