The Compliance Lead plays a pivotal role in ensuring that our compliance program not only meets governmental requirements but also drives process improvements across the compliance organization. We are looking for a candidate who is curious, analytical, and passionate about making a difference in the healthcare industry.
Key Responsibilities
Enhance Compliance Effectiveness: Advance the effectiveness of our compliance program by developing metrics, reporting frameworks, issue tracking, resolution strategies, and quality assurance processes.
Drive Process Improvement: Focus on standardizing and improving compliance processes, ensuring they are efficient and effective.
Issue Tracking and Resolution: Monitor and ensure the closure of compliance issues and opportunities, maintaining accountability throughout the process.
Support Regulatory Readiness: Prepare the compliance program for regulatory audits (e.g., CMS Program Audits ), reviews, and requests for proposals and information, ensuring we meet and exceed expectations.
Strategic Advisory: Provide expert advice and recommendations for leadership, contributing to informed decision-making.
Technical Leadership: Serve as a technical leader for the regulatory compliance team, guiding them through complex compliance issues.
Proactive Approach: Employ a consultative strategy to identify and address compliance challenges with innovative solutions.
Use your skills to make an impact
Required Skills:
Educational Background: Bachelor’s Degree
Experience:
Minimum of 3 years in an audit or compliance role within a health plan, provider-based industry, or consulting firm.
A total of 6+ years of professional experience.
At least 2 years in a project leadership capacity.
Data Proficiency: Experience in building, collecting, validating, and communicating large datasets.
Technical Skills: Advanced proficiency in Excel and PowerPoint, experience with CMS Program Audits, and familiarity with compliance program operations risk assessments.
Healthcare Knowledge: Strong understanding of healthcare-related data and Centers for Medicare and Medicaid Services (CMS) regulations.
Communication Skills: Excellent oral and written communication skills, with prior experience in presenting to and engaging with executive leadership.
Additional Information
Why Join Us?
We believe in the power of curiosity and innovation. By joining our team, you will be part of a forward-thinking organization that values your insights and encourages continuous improvement. If you are passionate about compliance and are eager to contribute to an organization focused on enhancing consumer experiences, we would love to hear from you.
Work From Home Requirements
Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet Service is NOT allowed for this role).
A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required.
Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our 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.Application Deadline: 04-29-2026About us
Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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What We Do
At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
