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

The Senior Compliance Professional ensures compliance with governmental requirements related to the administration of Specialty products with a focus on Medicare Supplement plans. The Senior Compliance Professional’s work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Senior Compliance Professional 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 Senior Compliance Professional’s primary focus is compliance with state and federal regulations that apply to Medicare Supplement plans, including implementing oversight monitoring plans and participating in external audits of these products.

The Senior Compliance Professional develops and implements proactive compliance policies and procedures focused on Medicare Supplement plans. The Senior Compliance Professional 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.

As a Senior Compliance Professional, you will be part of a fast-growing team who develops and maintains key relationships with Humana operational leaders. While working within assigned areas to optimize business results, you will:

• Research, understand and apply laws, regulations, and regulatory guidance for compliance issues with a focus on Medicare Supplement plans.
• Complete risk assessments, develop audit methodology and perform auditing and monitoring activities to prevent and detect issues of noncompliance and provide guidance on remedial actions to strengthen compliance controls and ensure compliance with state and federal laws and regulations.
• Analyze business requirements and complex issues, conduct research, and provide regulatory guidance to business partners, Law, and Enterprise Compliance associates and leaders with regard to compliance issues.
• Develop and track compliance metrics and other oversight tools and data analytics to help monitor and detect potential compliance issues.
• Present findings of monitoring and auditing efforts to business partners and Enterprise Compliance leaders and track issue to ensure appropriate and timely remediation.
• Review and analyze documents and data to identify what can be used to evidence meeting regulatory requirements
• Assist in document review and mock audits in preparation for external audits;
• Coordinate compliance related communication/interaction with regulators as needed and in response to external audit and exam submissions;
• Provide back-up and support to other Enterprise Compliance team members and perform other duties, as needed.

Use your skills to make an impact

Required Qualifications

• Bachelor’s degree in related field
• 2 to 5+ years' experience working in regulatory law, compliance, audit, risk management or health plan operations field
• Ability to analyze regulatory requirements and assist business areas with understanding impacts of requirements on their operations
• Knowledgeable in regulations governing health care industries
• Ability to manage multiple or competing priorities and meet deadlines

Preferred Qualifications

• Juris Doctor or Master of Business Administration or advanced degree
• Experience/Knowledge of Medicare Supplement
• Experience/Knowledge of health insurance claims

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

Scheduled Weekly Hours

40

Pay Range

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.

$86,300 - $118,700 per year

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

Description of Benefits

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.Application Deadline: 05-19-2025

About us

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.

​
Equal Opportunity Employer

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.