Senior Compliance Professional

Humana

1d • Remote

About The Position

Become a part of our caring community Are you passionate about navigating complex regulations and turning compliance into a strategic advantage? Join our team as a Senior Compliance Professional, where you’ll play a critical role in ensuring adherence to governmental and regulatory requirements while helping protect and strengthen the organization. In this dynamic role, you’ll tackle moderately complex to highly complex compliance initiatives, analyzing policies, data, and evolving regulations to identify risks and drive solutions. Your work will require deep critical thinking, sound judgment, and an in-depth evaluation of variable factors to resolve sophisticated issues and support informed decision-making across the organization. This is an opportunity to make a meaningful impact—partnering with key stakeholders, influencing compliance outcomes, and contributing to an environment where integrity and accountability are at the forefront. The Senior Compliance Professional is responsible for supporting organizational compliance by developing and maintaining effective relationships with internal stakeholders and external business partners. This role plays a key part in evaluating, monitoring, and sustaining adherence to all applicable regulatory and legislative requirements.

Requirements

• 5 or more years of demonstrated experience and understanding of regulations governed by the Department of Insurance and CMS
• 2-3 years of Audit or consulting experience
• Experience with metrics and reporting
• 2-3 years of Managed Care experience

Nice To Haves

• Active RN
• Care coordination/ care management experience
• Graduate or advanced degree

Responsibilities

• Establish and maintain productive working relationships with internal departments and assigned external delegates to support ongoing compliance objectives.
• Track, analyze, report, and communicate audit activities and findings to delegates and relevant internal stakeholders in a timely and accurate manner.
• Review and evaluate delegates’ policies, procedures, and operational practices to ensure alignment with regulatory and contractual requirements.
• Identify compliance gaps and develop corrective action plans, partnering with delegates through resolution to ensure issues are addressed effectively and sustained.
• Serve as a compliance subject matter resource, providing consultation and guidance to support consistent and compliant business operations.
• Participate in special projects and process improvement initiatives designed to enhance departmental efficiency and effectiveness.

Benefits

• Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees