Policy Governance Professional 2

Humana

2d•$65,000 - $88,600•Remote

About The Position

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.

Requirements

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

Nice To Haves

Graduate or advanced degree
Background in policy or compliance

Responsibilities

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

Benefits

Humana offers a variety of benefits to promote the best health and well-being of our employees and their families.
We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:
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