Senior Compliance Professional

San Antonio, Texas, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Health InsuranceIndustries

Requirements

Candidates must possess a Bachelor's degree or have at least 3 years of experience leading a sales team. A minimum of 1 year of experience presenting to leadership and 1 year of experience in metrics and reporting are required. Knowledge and understanding of laws and regulations governed by the Department of Insurance and CMS are essential. Preferred qualifications include a graduate or advanced degree, audit or consulting experience, and 1 year of experience in coaching others, ideally sales agents. The role requires the ability to prioritize and manage multiple demanding projects.

Responsibilities

The Senior Compliance Professional is responsible for ensuring compliance with governmental requirements and developing and implementing compliance policies and procedures. This role involves researching compliance issues, recommending changes to ensure compliance with contract obligations, and influencing department strategy. The professional will make decisions on moderately complex to complex issues regarding the technical approach for project components and will work without direction, exercising considerable latitude in determining objectives and approaches to assignments.

Skills

Compliance

Policy Development

Regulatory Research

Department of Insurance Regulations

CMS Regulations

Metrics

Reporting

Project Management

Presentation Skills

Audit

Consulting

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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