Risk Adjustment Senior Compliance Professional

Humana Inc. Louisville , KY 40202

Posted 2 months ago

Description

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.

Responsibilities

The Senior Compliance Professional develops and implements compliance policies and procedures. Researches compliance issues and recommends changes that assure compliance with contract obligations. Maintains relationships with government agencies. Coordinates site visits for regulators, coordinates implementation and compliance with corrective action plans, as needed. Begins to influence department's strategy. 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.

The individual in this position will partner closely with risk adjustment teams to evaluate new initiatives to ensure appropriate processes, procedures and policies are implemented to ensure compliance. In addition, the associate will be responsible for evaluating existing processes to identify opportunities for improvement and work collaboratively with the business units to drive improvement.

Required Qualifications

  • Bachelor's degree or equivalent

  • 3 years of technical experience

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

Preferred Qualifications

  • Graduate or advanced degree

  • Experience with metrics and reporting

  • Project Management Professional (PMP) certification

  • Six Sigma certification

Additional Information

Scheduled Weekly Hours
40


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