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Job Details

Senior Compliance Professional - Medicaid State Reporting

Location
Milwaukee, WI, United States

Posted on
Sep 15, 2022

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Description

Senior Compliance Professional ensures compliance with governmental requirements as they relate to Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

The Senior Compliance Professional 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. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction.


Managing state reporting for Florida market (contracts and gathering data for reports)


Required Qualifications


Bachelor's degree or Equivalent Work Experience (5 years of healthcare, insurance, or financial services experience)
3 or more years of Compliance and/or project/process management experience
Ability to work in a deadline-driven organization
Ability to manage multiple projects/assignments while working with various departments to obtain data
Comprehensive working knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
Strong attention to detail
Success in developing and managing working relationships within a highly matrixed business environment
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.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information


Preferred Qualifications


Graduate or advanced degree
Audit or consulting experience
Prior experience analyzing data and metrics to influence change in departmental processes
Prior health insurance industry experience
Experience in data visualization tools (Power BI, Tableau, etc.)
Medicaid experience/knowledge


Additional Information

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.

Additional Information (COVID)

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Additional Information

Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/yammer and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.

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

Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ****

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