Humana

Director, Compliance - Specialty and Military Products

San Antonio, Texas, United States

Not SpecifiedCompensation
Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Insurance, Government & MilitaryIndustries

Requirements

Candidates should possess a Bachelor’s degree in a relevant field, along with a minimum of 10 years of experience in regulatory compliance, specifically within the healthcare or pharmaceutical industries. Demonstrated expertise in navigating complex governmental requirements and regulations is essential, as is a strong understanding of compliance programs and risk mitigation strategies. Excellent communication and leadership skills are also required.

Responsibilities

The Director of Regulatory Compliance will develop and implement comprehensive compliance programs for Humana’s Specialty and Military products and contracts, managing dedicated compliance teams to oversee these programs. They will be responsible for conducting annual risk assessments, auditing and monitoring work plans, overseeing corrective action plans, researching compliance issues, and providing guidance to business partners to ensure adherence to regulatory and contract obligations. The Director will also analyze business requirements, deliver regulatory interpretation, advise internal and external business units, and contribute to strategy development, while maintaining relationships with government agencies and external auditors.

Skills

Regulatory Compliance
Risk Management
Auditing
Monitoring
Corrective Action
Government Relations
Leadership
Communication

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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