Senior Compliance Professional

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The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Regulatory Compliance – State Enterprise Intake and Implementation – Senior Compliance Professional

The Senior Compliance Professional implements new statues, regulations, rules and other regulatory guidance issued by state and federal regulators across the enterprise. Coordinates business partner engagement and implementation of rules. Researches compliance issues and recommends changes that ensure compliance with regulatory obligations. Provides compliance guidance and direction to business partners. Monitors metrics and other oversight tools that track implementation activity. Recommends new measures of compliance performance. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding implementation components. Exercises considerable latitude in determining objectives and approaches to assignments.

The Senior Compliance Professional's primary focus will be to implement new federal and state rules, including PBM, across the enterprise.

Key responsibilities may include:
- Serve as the subject matter expert and point-of-contact for individual state and federal implementations, leading implementation activity from onset to conclusion.
- Research, understand, and apply laws, regulations, and regulatory guidance for federal and state compliance issues.
- Analyze business requirements and complex issues, conduct research, and provide regulatory guidance to business partners, Law, Risk, and Compliance associate and leaders with regard to federal and state implementations.
- Develop and track a caseload of implementations spanning both enterprise-wide and state rules.
- Partner with Law, Risk, Compliance, and other operational partners to ensure an accurate and timely implementation.
- Lead and participate in meetings, providing compliance guidance and direction.
- Provide back-up and support to other Enterprise Compliance team members, and perform other duties, as needed.

Use your skills to make an impact

Required Qualifications
- 5 or more years’ experience in healthcare compliance, regulatory implementations, and or Pharmacy Benefit Management

- Knowledge/understanding of laws and regulations governed by the Department of Insurance and CMS

Preferred skills
- Bachelor's degree or higher
- Experience with compliance systems, metrics, and reporting

Additional information:

This role is an individual contributor.

This role is fully remote within the US.

You will not have any travel within this position.

In this role you will report to an Associate Director.

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 required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay 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