Senior Compliance Professional
4 days ago
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.
- 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.
- 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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