高级合规专业人员
Senior Compliance Professional
成为我们关怀社区的一员
高级合规专员确保符合政府要求。高级合规专员的工作任务涉及中等复杂到复杂的议题，需要对各种因素进行深入评估。监管合规 – 州企业接入与实施 – 高级合规专员
高级合规专员负责在全公司范围内实施州和联邦监管机构发布的新的法规、规章和其他监管指导。协调业务合作伙伴的参与和规则的实施。研究合规问题并推荐确保符合监管义务的变更。向业务合作伙伴提供合规指导和方向。监控指标和其他监督工具以跟踪实施活动。建议新的合规绩效措施。开始影响部门的战略。对实施组件的中等复杂到复杂问题做出决策。在确定目标和方法方面有相当大的自主权。
高级合规专员的主要重点是实施新的联邦和州法规，包括PBM，在整个企业范围内。
主要职责可能包括：
- 作为各州和联邦实施的专家和联系人，从开始到结束领导实施活动。
- 研究、理解和应用联邦和州合规问题的法律、法规和监管指导。
- 分析业务需求和复杂问题，进行研究，并就联邦和州实施向业务合作伙伴、法律、风险和合规助理及领导提供监管指导。
- 制定并跟踪涵盖企业范围和州法规的实施案件。
- 与法律、风险、合规和其他运营合作伙伴合作，确保准确和及时的实施。
- 领导和参与会议，提供合规指导和方向。
- 为其他企业合规团队成员提供支持，并根据需要执行其他职责。
运用你的技能产生影响
所需资格
· 在医疗保健合规、监管实施和/或药房福利管理方面有5年或更多经验
· 熟悉法律法规和监管要求
查看英文原文
Become a part of our caring community
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.Regulatory Compliance – State Enterprise Intake and Implementation – Senior Compliance Professional
The Senior Compliance Professional implements new statues, regulations, rules and other regulatory guidance issued by state and federal regulators across the enterprise. Coordinates business partner engagement and implementation of rules. Researches compliance issues and recommends changes that ensure compliance with regulatory obligations. Provides compliance guidance and direction to business partners. Monitors metrics and other oversight tools that track implementation activity. Recommends new measures of compliance performance. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding implementation components. Exercises considerable latitude in determining objectives and approaches to assignments.
The Senior Compliance Professional's primary focus will be to implement new federal and state rules, including PBM, across the enterprise.
Key responsibilities may include:
- Serve as the subject matter expert and point-of-contact for individual state and federal implementations, leading implementation activity from onset to conclusion.
- Research, understand, and apply laws, regulations, and regulatory guidance for federal and state compliance issues.
- Analyze business requirements and complex issues, conduct research, and provide regulatory guidance to business partners, Law, Risk, and Compliance associate and leaders with regard to federal and state implementations.
- Develop and track a caseload of implementations spanning both enterprise-wide and state rules.
- Partner with Law, Risk, Compliance, and other operational partners to ensure an accurate and timely implementation.
- Lead and participate in meetings, providing compliance guidance and direction.
- 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
· 5 or more years’ experience in healthcare compliance, regulatory implementations, and or Pharmacy Benefit Management
· Knowledge/understanding of laws and regulations governed by the Department of Insurance and CMS
Preferred skills
- Bachelor's degree or higher
- Experience with compliance systems, metrics, and reporting
Additional information:
This role is an individual contributor.
This role is fully remote within the US.
You will not have any travel within this position.
In this role you will report to an Associate Director.
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours
40Pay 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 yearThis 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 09-24-2026
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
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.
Originally posted on Himalayas