Compliance Lead Compliance Program Effectiveness

Profile

Description

The Compliance Lead ensures compliance with governmental requirements and works on problems of diverse scope and complexity ranging from moderate to substantial utilizing reporting and analytics. Exercises independent judgment and decision making on complex issues requiring analysis of variable internal and external factors and determining the best course of action.

Responsibilities

Key responsibilities include:

Responsible for effectiveness of compliance program which includes metrics, reporting, issue tracking and resolution, and quality assurance

Focuses on process improvement and standardization

Accountable for delivering process improvements and automation to compliance scorecard

Tracks issues and opportunities to closure

Monitors compliance assessment activity and work plans

Advises and makes recommendations to leadership

Serves as a technical leader for regulatory compliance team

Optimizes reporting and analytics capabilities and cognitive learning and automated solutions to deliver actionable reporting, well-rounded insights, and proactive recommendations

Exercises independent judgment and decision making on complex issues requiring analysis of variable internal and external factors and determining the best course of action

Deploys a proactive and consultative approach to providing strategic thought leadership to identify and address complex issues

Works under minimal supervision

Will report to the Director, Enterprise Compliance Program Effectiveness

Required Qualifications

Bachelor's Degree

5 years of Health Plan or provider-based industry experience

3 years of data analytics experience

2 years of project leadership experience

Advanced experience with building, collecting, validating, and communicating large sets of data, using a tool such as PowerBI

Proficiency in understanding Healthcare-related data and Centers for Medicare and Medicaid Services (CMS) regulations

Excellent oral and written communication skills, previous experience presenting and interacting with executive leadership

WAH 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

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Advanced graduate degree

Project Management Professional (PMP) certification

Six sigma certification

Experience in an audit, consulting or compliance role for a Health Plan or provider-based industry

Leadership experience

Additional Information

Interview Format

As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.

If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com