Senior Compliance Professional

4 days ago


Columbia, South Carolina, United States Humana Full time
Job Title: Senior Compliance Professional

Humana is seeking a highly skilled Senior Compliance Professional to join our team in Puerto Rico. As a key member of our compliance team, you will play a critical role in ensuring the company's compliance with regulatory requirements and maintaining a strong compliance program.

Key Responsibilities:
  • Develop and implement a plan to monitor and audit business processes related to Humana's Medicare and Commercial Dental and Vision products in Puerto Rico.
  • Research, understand, and apply federal and state laws, regulations, and regulatory guidance to ensure compliance.
  • Develop audit methodology and perform auditing and monitoring activity to prevent and detect issues of noncompliance.
  • Provide regulatory guidance to business partners, Law, Risk, and Compliance associates, and leaders on Dental and Vision compliance issues.
  • Develop and track compliance metrics to help monitor and detect potential compliance issues.
  • Partner with Regulatory Compliance team members on regulatory outreach and serve as a subject matter expert for Humana Puerto Rico's Dental and Vision products during external audits.
Requirements:
  • Bachelor's degree in a related field.
  • Fluent in both English and Spanish.
  • Advanced experience working in a Legal, Risk, or Compliance-related or healthcare-related field.
  • Demonstrated ability to analyze regulatory requirements and assist business areas with understanding impacts of requirements on their operations.
  • Strong communication skill with ability to influence effectively and present to leadership.
  • Strong attention to detail and focus on process and quality.
  • High level of emotional intelligence.
  • Ability to work independently and utilize excellent judgment.
Preferred Qualifications:
  • J.D. or other graduate degree.
  • Knowledge/understanding of laws and regulations governed by CMS and/or various Departments of Insurance and other regulatory agencies.
  • Experience interacting with governmental agencies.
  • Experience with metrics, KPIs, and other data analytics.

Humana offers a competitive benefits package, including medical, dental, and vision benefits, 401(k) retirement savings plan, time off, and other opportunities. We are an equal opportunity employer and welcome applications from diverse candidates.



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