Compliance Lead - Military Contracting and Products

Job Description:

Become a part of our caring community and help us put health first

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The Regulatory Compliance Lead - Military Products ensures compliance with governmental requirements. The Lead implements compliance programs in support of Humana’s Military products, maintains annual auditing and monitoring work plans, researches compliance issues and recommends changes that assure compliance with regulatory and contractual obligations. The Regulatory Compliance Lead maintains relationships with internal business partners and works across Humana operational units to enhance data analytics and operational improvement efforts. The work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

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The Lead will analyze business requirements, provide research and regulatory interpretation, and advise internal business units and external business partners in delivering results in a manner that minimizes compliance risk exposure for the Company. The Lead’s primary focus is compliance with contract requirements, state and federal regulations that apply to Humana’s Military products. The Lead manages other associates as assigned in support of these efforts.

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The Regulatory Compliance Lead develops and implements proactive compliance policies and procedures focused on Humana Military products. The Lead will analyze business requirements, provide research and regulatory interpretation, and advise internal business units and external business partners in delivering results in a manner that minimizes compliance risk exposure for the Company. Complete risk assessments and develop audit and monitoring work plan to prevent, detect and correct issues of noncompliance, and provide guidance on remedial actions to strengthen compliance controls and ensure compliance with state and federal laws and regulations. Review and analyze documents and data to identify what can be used to evidence meeting regulatory requirements. Analyzes identified issues and exam findings to proactively identify gaps and areas for improvement. Coordinates implementation and compliance with corrective action plans, as needed. 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. Manages one full time associate. Upon hire, candidate is expected to successfully receive approval for government security clearance (Via National Background Investigation Services NBIS).

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Requirements

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Humana is seeking a Regulatory Compliance Lead to manage compliance programs for Humana’s Military products. The Regulatory Compliance Lead develops and implements proactive compliance policies and procedures focused on Humana Military products. The Lead will analyze business requirements, provide research and regulatory interpretation, and advise internal business units and external business partners in delivering results in a manner that minimizes compliance risk exposure for the Company. Complete risk assessments and develop audit and monitoring work plan to prevent, detect and correct issues of noncompliance, and provide guidance on remedial actions to strengthen compliance controls and ensure compliance with state and federal laws and regulations. Review and analyze documents and data to identify what can be used to evidence meeting regulatory requirements. Analyzes identified issues and exam findings to proactively identify gaps and areas for improvement. Coordinates implementation and compliance with corrective action plans, as needed. Manages one full time associate. While working within assigned areas to optimize business results, you will:

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• Provide ongoing oversight and monitoring of Military products and contracts to promote compliance and minimize risk for the Enterprise;
• Leads completion of annual risk assessments and work plans to audit and monitor performance across products and segments;
• Complete audits and monitor performance, report top risks to leadership, complete remediation plans and other information as appropriate;
• Review and analyze policies and process documents and data to identify what can be used to evidence meeting compliance and regulatory standards;
• Research compliance issues and recommends changes that assure compliance with regulatory and contract obligations;
• Manage compliance associate(s) in the interpretation of regulatory and contract requirements to be implemented by appropriate Humana Departments and/or external business partners;
• Work across Humana operational units and product lines to enhance data analytics and operational improvement efforts;
• Present at compliance oversight committee meetings as required regarding risk mitigation and remediation plans as needed;
• Build relationships with segment leadership and shared services business units;
• Participate in external audits as needed, working with business partners and other compliance teams.

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Required Qualifications

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Use your skills to make an impact 

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• Bachelor’s degree
• 3 to 5 +years of experience working in a Compliance-related, risk management and/or managed care-related field 
• 2 years of management and/or leadership experience
• Strong communication skills with the ability to influence effectively
• Knowledgeable in regulations governing health care industries

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Preferred Qualifications

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• Juris Doctor or Masters of Business Administration
• Military experience preferred
• Knowledgeable in compliance programs and processes 
• Experience working with regulatory agencies, including state departments of health insurance, DHA and/or CMS

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Additional Information

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• Upon hire, candidate is expected to successfully receive approval for government security clearance (Via National Background Investigation Services NBIS)

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Travel:

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

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Scheduled Weekly Hours

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40

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Pay Range

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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.

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$115,200 - $158,400 per year

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This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

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Description Of Benefits

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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.

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About Us

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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.

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Equal Opportunity Employer

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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.