Director of Compliance Provider and Clinical Services

Profile

Description

The Director, Compliance ensures compliance with governmental requirements. The Director, Compliance requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

Responsibilities

The Director, Compliance 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. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy.

Required Qualifications


Master's Degree

8 or more years of technical skillset working in Provider or Practice Group setting

5 or more years of management experience

Advanced experience working in compliance, risk management, or managed-care field

Advanced experience working with Provider and Physician Office compliance

Experience in documentation, coding and risk adjustment assessments

Strong communication skills with the ability to influence effectively

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


Additional Information


Position will start work from home and move into a traditional office setting


Scheduled Weekly Hours

40

About Us

Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.

Equal Opportunity Employer

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