Company name
Humana Inc.
Location
Ridgeland, MS, United States
Employment Type
Full-Time
Industry
Compliance
Posted on
Aug 18, 2022
Profile
Job Information
Humana
Compliance Prof 2/Process and Market Support- Remote in US
in
Ridgeland
Mississippi
Description
Do you crave new challenges and solving problems? Are you looking for an opportunity to grow in the Medicaid business? Are you interested in utilizing your critical thinking skills to improve the Humana processes and associate experience? As a Critical Inquiry Process and Market Support Professional 2, you will work to convert data into actionable insights and improve operational efficiencies. You will be responsible for combining and analyzing diverse types of data to extract actionable discoveries made by business partners and Regulatory agencies. You will present and share data points with various internal departments.
Responsibilities
Where you Come In
Do you crave new challenges and solving problems? Are you looking for an opportunity to grow in the Medicaid business? Are you interested in utilizing your critical thinking skills to improve the Humana processes and associate experience? As a Critical Inquiry Process and Market Support Professional 2, you will work to convert data into actionable insights and improve operational efficiencies. You will be responsible for combining and analyzing diverse types of data to extract actionable discoveries made by business partners and Regulatory agencies. You will present and share data points with various internal departments.
Responsibilities
Ensure accountability of State Regulations and Agency expectations
Continuous collaboration with our organization and business partners to fulfill data needs
Prepare and present data to cross-functional departments on a regular basis
Identify and analyze gaps in business process which includes remediation
Collaborate closely with the Resolution Process team to create, update, and implement new and existing processes
Accountable for identifying and cascading pertinent information
Research and identify compliance issues
Conducting a comprehensive analytic review of all documents related to monthly state data
Understand and relate department, segment, organizational strategy and operating objectives
Makes decisions regarding own work methods, in ambiguous situations, and require minimal direction
Support Team Lead and Leaders as needed
What Humana Offers
We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education.
Required Qualifications - What it takes to Succeed
Minimum of 2 years' experience of health insurance to include each of the following: strong claims investigational skills; extensive background in Service Operations; and a strong understanding of CAS or MTV (Legacy Systems)
Excellent Microsoft skills Word and Excel
Excellent organizational and investigational skills
Written correspondence/professional writing experience
Requires an 18-month time in job commitment
Strong Analytical skills
Ability to manage multiple or competing priorities and meet deadlines
The hours are a minimum of 40 hours per week Monday- Friday. Core hours are between 8:00AM and 5:00 PM EST. Additional hours can be expected due to compliance deadlines provided by the state.
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.
If progressed to offer, you will be required to:
Provide proof of full vaccination OR
Commit to weekly testing, following all CDC protocols, OR
Provide documentation for a medical or religious exemption consideration.
This policy will not supersede state or local laws. Requests for these exemptions should be submitted at least 2 weeks prior to your scheduled first day of work.
Preferred Qualifications
Bilingual (English and Spanish); with the ability to read, write, and speak English and Spanish
Prior experience with Medicaid
Bachelor's degree
Additional Information - How we Value You
Benefits starting day 1 of employment
Competitive 401k match
Generous Paid Time Off accrual
Tuition Reimbursement
Parent Leave
Go365 perks for well-being
Work-At-Home Requirements
WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Interview Format
As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Scheduled Weekly Hours
40
Company info
Humana Inc.
Website : http://www.humana.com