Description

The Compliance Professional 2 joins Humana's Regulatory Compliance, Audit Coordination team to support State and Federal audits. The role receives audit requests from examiners, partners with Law, Risk, and Compliance subject matter experts to respond, and reviews the responses for accuracy and completeness. The role is a great opportunity to work with professionals throughout the enterprise on significant healthcare compliance topics.

Responsibilities

The Compliance Professional 2 leads incoming regulatory audits, coordinates audit responses, coordinates site visits for State and Federal agencies, and monitors corrective action plans, if applicable. The role researches exam issues/requests and partners with subject matter experts s to provide responses while obtaining the proper approvals. The role has the opportunity to influence the departments strategy by recommending updates to department procedures.

Responsibilities:

• Support multiple external audit requests performed by state Departments of Insurance and Federal agencies, such as Health and Human Services' Centers for Medicare and Medicaid Services (CMS)
• Review and monitor the organizations responses to audit requests and advise subject matter experts
• Monitor invoices and payments for exam related expenses
• Monitor and report on audit status to Law, Risk, and Compliance stakeholders
• Develop and maintain documentation related to regulatory requests
• Records audit information in internal Humana systems and external agency systems
• Serve as a point of contact for State and Federal agencies
• Supports compliance oversight activities including compliance monitoring and overseeing implementation of policies/procedures and regulatory changes
• Support the establishment of trusting relationships with internal business partners and external agencies
• Report and escalate compliance risks to ensure timely resolution, where needed
• Regularly participate in status meetings and provide updates on exam requests

Required Qualifications

• Bachelor’s Degree
• Basic project management skills
• Basic regulatory compliance knowledge
• Ability to gracefully and quickly adapt to changes in auditor requests
• Ability to occasionally work from office locations, as needed
• Proficient with MS Office; including Teams and SharePoint
• Proficient written communication skills

Preferred Qualifications

• Professional certifications such as CPA, CIA, CISA, CISSP, CFA or PMP
• 2-5 years of law, risk, compliance, internal audit, public audit, or project management experience
• 2-5 years of healthcare or insurance experience
• Knowledge of Humana’s cultural values, products, policies, and procedures

Scheduled Weekly Hours

40