Compliance Lead - Remote Wisconsin

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Job Information
Humana
Compliance Lead - Remote, Wisconsin
in
De Pere
Wisconsin
Description
iCare is a wholly-owned subsidiary of Humana and the second largest DSNP plan in the state of Wisconsin. iCare services members across the following state Medicaid programs: BadgerCare Plus, SSI, and Family Care Partnership.
Human is seeking a Compliance Lead who will ensure contract compliance with governmental requirements and functions as the direct line of communication with the Wisconsin Department of Health Services (WDHS) as our account manager. The Compliance Lead works on problems of diverse scope and complexity ranging from moderate to substantial.
Responsibilities
The Compliance Lead 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.
Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision.
Uses independent judgment requiring analysis of variable factors and determining the best course of action.
Required Qualifications
Bachelor's degree.
5 years of experience in auditing, consulting or compliance-related field.
Must reside in Wisconsin.
Previous leadership experience.
Advanced experience with building, collecting, validating, and communicating large sets of data.
Experience working with regulatory agencies, including state departments of health and/or CMS.
This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.
Must have a separate room with a locked door that can be used as a home office, to ensure you have absolute and continuous privacy while you work.
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.
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
Master's Degree or an advanced degree in business, law or a related field.
Additional Information
Travel:
Up to 20% to Madison, WI.
Direct Reports:
1 associate.
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

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