Humana Senior Compliance Professional in Vancouver, Washington
The Senior Compliance Professional ensures compliance with governmental requirements. 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.
The Senior Compliance Professional develops and implements proactive compliance policies and procedures. Researches compliance issues and market conditions and recommends changes that assure compliance with regulatory and contractual obligations. Coordinates implementation and compliance with corrective action plans, as needed. Analyzes identified issues and exam findings to proactively identify similar gaps elsewhere within the Company. Provides compliance guidance, direction and compliance risk assessment to assigned business partners, conducts compliance reviews of business partner operations. Creates automation of metrics and other oversight tools that indicate business area compliance. Recommends new measures of compliance performance. Works with systems to track issues and corrective actions, when needed. Helps to influence compliance strategy for the Group, Military, and Specialty segment. 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.
The Senior Compliance Professional's primary focus will be to develop and implement a plan to leverage data analytics and risk assessments to prevent, detect, and resolve compliance issues within the Group, Military & Specialty segment.
Key responsibilities may include:
● Research, understand and apply laws, regulations, and regulatory guidance for compliance issues within the Group, Military & Specialty segment.
● Develop audit methodology and perform auditing and monitoring activity 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 that impact the Group, Military & Specialty segment.
● 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.
● Lead and participate on committees, providing compliance guidance and direction.
● Provide back-up and support to other Enterprise Compliance team members and perform other duties, as needed.
● Bachelor's degree
● 5+ years of experience in regulatory law, compliance, audit, consulting and/or risk management.
● Demonstrated ability to run large -scale, highly-visible programs with responsibility for multiple project teams
● Demonstrated ability to analyze regulatory requirements and assist business areas with understanding impacts of requirements on their operations
● Demonstrated ability to utilize analytical skills, data and analytics to understand broad impacts of regulatory requirements
● Demonstrated ability to communicate with leadership and knowledge of when to escalate issues
● High level of emotional intelligence
● Knowledge of the healthcare insurance industry
● Knowledge/understanding of laws and regulations governed by the Department of Insurance and other regulatory agencies
● Experience with metrics and reporting
● J.D. or other graduate degree
● Experience interacting with governmental agencies
Scheduled Weekly Hours
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 https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
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