Policy Governance Professional

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

The Policy Governance Professional 2 policy Governance is the combination of Compliance processes established and executed that are reflected in the organization’s structure and how it is managed and led toward achieving goals. The Policy Governance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Policy Governance Professional 2 supports the ongoing development, review, and management of Utilization Management (UM) policies and procedures. This role works closely with UM governance and relevant committees, ensuring documentation and reporting align with regulatory standards and organizational objectives. The position also assists with monitoring and reporting quality metrics, and is responsible for preparing clear, accurate written materials to support compliance and continuous improvement initiatives.

• Assist with the development, review, and maintenance of UM policy and procedure documentation, ensuring compliance with regulatory requirements and enterprise standards.
• Support UM governance activities and provide committee support by preparing meeting materials, documenting meeting minutes, and tracking action items.
• Collect, analyze, and report on UM quality metrics to inform decision-making and support continuous improvement efforts.
• Prepare clear, concise, and accurate written communications, summaries, and reports related to UM governance, quality metrics, and policy activities.
• Facilitate communication and training related to UM policy requirements, reporting resources, and compliance protocols.
• Assist with the escalation and documentation of suspected policy violations in accordance with established Humana procedures.

• Bachelor’s degree
• Less than 5 years of technical experience
• Experience with UM operations, policy governance, committee support, and/or quality reporting in a healthcare environment.
• Strong written communication and documentation skills.
• Familiarity with regulatory standards (e.g., HIPAA, HITRUST, NIST) and compliance practices.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

• Graduate or advanced degree
• Background in policy or compliance

• 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.
• 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.

• Health benefits effective day 1
• Paid time off, holidays, volunteer time and jury duty pay
• Recognition pay
• 401(k) retirement savings plan with employer match
• Tuition assistance
• Scholarships for eligible dependents
• Parental and caregiver leave
• Employee charity matching program
• Network Resource Groups (NRGs)
• Career development opportunities

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.

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from  with instructions on how to add the information into your official application on Humana’s secure website.

While this is a remote position, occasional travel to Humana’s offices for training…