Humana

Associate Director, Regulatory Intake Compliance

San Antonio, Texas, United States

Not SpecifiedCompensation
Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
Health Insurance, HealthcareIndustries

Requirements

Candidates must possess a Bachelor's degree and have 6 or more years of technical experience, with at least 2 years in management. Advanced experience in compliance, risk management, or the managed-care field is required, along with strong communication and influencing skills, and the ability to exercise sound judgment. Experience in leadership within compliance or risk management is highly preferred, as is an MBA or Juris Doctor degree.

Responsibilities

The Associate Director, Regulatory Intake Compliance is responsible for enterprise-wide regulatory monitoring, including communicating new or amended regulations and implementing quality assurance processes. They will oversee a team of subject matter experts, advise business units to reduce compliance risk, and develop/maintain departmental policies and procedures. Responsibilities include managing data within Enterprise Solution Point (ESP), coordinating inter-departmental meetings, maintaining stakeholder relationships, leading complex problem-solving, and developing consistent end-to-end regulatory processes. They will also define metrics for tracking regulatory distribution and implementation, develop post-implementation compliance assessment programs, and build a high-performance team.

Skills

Regulatory Compliance
Policy Development
Procedure Development
Workflow Management
Risk Assessment
Data Analytics
Process Improvement
Stakeholder Management
Government Regulations
Team Leadership
Operational Problem Solving

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.
Rising medical costs and tightening Medicare reimbursements may strain financial performance.
Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.
The company emphasizes inclusivity, offering free language interpreter services for accessibility.
Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.
The company is the first insurer to cover TMS therapy for adolescent depression.
Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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