Senior Compliance Professional

Employment Type: Full-time Location Type: Remote Workstyle: Remote, work at home. Core workdays and hours: Monday through Friday, 8:00 am-5:00 pm Eastern Standard Time (EST). Travel: Up to 15% within the United States.

Position Overview

Humana Healthy Horizons is seeking a Senior Compliance Professional to support audit preparation, internal controls evaluation, and compliance efforts across the organization. This role is pivotal in ensuring organizational readiness for external audits. The Senior Compliance Professional will handle moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

• Develops and maintains detailed project plans, timelines, and status reports for all audit activities.
• Manages audit readiness initiatives for operational and compliance audits.
• Collaborates across departments to assess, design, and implement improvements.
• Coordinates with internal stakeholders to gather and validate audit documentation and evidence.
• Maintains a centralized repository of audit findings, management responses, and evidence of corrective actions.
• Tracks and reports audit metrics.
• Coordinates site visits for regulators, coordinates implementation and compliance with corrective action plans, as needed.
• Serves as a point of contact for auditors during fieldwork and onsite phases.
• Begins to influence department’s strategy while maintaining current knowledge of best practices in audit and compliance.
• Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction.
• Exercises considerable latitude in determining objectives and approaches to assignments.

Requirements

• Must reside in the Eastern or Central time zone in the United States.
• Bachelor's degree or 3+ years of managed care work experience.
• 3+ years of Compliance experience.
• Demonstrated experience in an audit, compliance, or regulatory role in health insurance.
• Proven ability to work in a deadline-driven organization with a strong attention to detail.
• Demonstrated ability to manage multiple projects/assignments while working with various departments to obtain data, and ensure deliverables are timely and accurate.
• Success in developing and managing working relationships within a highly matrixed business environment.
• Strong written and verbal communication skills; able to effectively communicate in a clear manner.

Preferred Qualifications

• Medicaid experience/knowledge.
• Audit or consulting experience.
• Experience in data visualization tools (Power BI, Tableau, etc.).

Work at Home Requirements

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• 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.

Benefits

Benefits are effective on day 1. Full-time associates enjoy competitive pay and a comprehensive benefits package that includes 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more…

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology.