Senior Compliance Professional
5 days ago
Become a part of our caring community and help us put health first
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 focus of this role is Medicare Pharmacy and Part D.
The Senior Compliance Professional will analyze business requirements, provide research and regulatory interpretation, and advise internal business units and external business partners in delivering results in a manner that minimizes compliance risk exposure for the Company. The Senior Compliance Professional also develops and maintains key relationships both internally with Humana operational leaders as well as externally with our business partners. The Senior Compliance Professional’s primary focus will be to develop and implement a plan to monitor and audit business processes to prevent, detect, and resolve compliance issues related to Humana’s pharmacy services across segments. While working within assigned areas to optimize business results, you will:
Cultivate relationships with key partners to ensure compliance alignment on strategic initiatives;
Research, understand and apply laws, regulations, and regulatory guidance as applicable for pharmacy services across various segments;
Conduct risk assessments and perform auditing and monitoring activities 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;
Develop and track compliance metrics 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;
Oversee development and progress of issue remediation; review and analyze documents and data to identify what can be used to evidence meeting regulatory standards;
Provide back-up and support to other Enterprise Compliance team members and perform other duties, as needed;
Work across Humana operational units and product lines to enhance data analytics and operational improvement efforts;
Support resolution of CMS inquiries including analyzing complaints, questions, and complex situations;
Use your skills to make an impact
Required Qualifications
Bachelor’s degree in related field or equivalent work experience
Experience working in a Compliance-related or managed care-related field or pharmacy
Experience working with regulatory agencies
Knowledgeable in process improvement and metrics development
Knowledgeable in regulations governing health care industries
Experience with pharmacy operations and/or claims processing in a pharmacy setting
Intermediate Microsoft Excel, Word and PowerPoint proficiency
Preferred Qualifications
Juris Doctor or Master of Business Administration
3 plus years of experience in Health Plan Compliance or Health Plan Operations
Familiarity with Medicare pharmacy laws or regulations
Additional Information
Scheduled Weekly Hours
40
Pay 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.
$84,600 - $116,300 per year
This 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.
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 veteran status. It is also the policy of Humanato take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.
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.
#J-18808-Ljbffr-
Senior Care Professional
3 weeks ago
Winston-Salem, North Carolina, United States Sunrise Senior Living Full timeUnlock Your Potential as a Senior Care ProfessionalAt Sunrise Senior Living, we believe that our caregivers are our greatest resource. That's why we're seeking highly motivated and compassionate individuals to join our team as Senior Care Professionals.About the Opportunity:We offer a competitive compensation package, including an estimated annual salary of...
-
Salem, Oregon, United States Bonaventure Senior Living Full timeOur MissionWe are committed to providing exceptional care and support to our residents, ensuring their physical, emotional, and social needs are met. Our team of caregivers and medication aides play a vital role in delivering this mission.About the RoleThis position involves providing personal care assistance to our residents, including bathing, dressing,...
-
Senior Healthcare Professional
3 weeks ago
Salem, Indiana, United States American Senior Communities Full timeSalary and BenefitsThe estimated annual salary for this position is $**85,000-$110,000**, depending on experience. In addition to competitive compensation, American Senior Communities offers a comprehensive benefits package, including medical, dental, and vision coverage, 401(k) retirement plan, and generous paid time off.
-
Risk and Compliance Professional
2 weeks ago
Salem, New Hampshire, United States The Crosby Company Full timeAbout this opportunity at The Crosby Company:The ideal candidate will have a strong background in risk management and possess excellent analytical, communication, and project management skills. They will be responsible for developing and implementing risk management strategies, conducting regular risk assessments, and providing recommendations to senior...
-
Senior Care Director
3 weeks ago
Winston-Salem, North Carolina, United States Sunrise Senior Living Full timeAbout the RoleAs a Senior Care Director at Sunrise Senior Living, you will play a vital role in championing quality of life for our residents. You will be responsible for overseeing the health and wellness of our resident population, providing strategic leadership for resident care, and ensuring compliance with federal, state, and local regulations.
-
Personal Support Professional
2 weeks ago
Salem, Oregon, United States Senior Helpers - Salem Full timeAbout the JobWe are seeking a highly skilled and compassionate Caregiver Assistant to join our team at Senior Helpers - Salem. As a Caregiver Assistant, you will play a vital role in providing personalized care and support to seniors in their own homes.Estimated Salary: $40,000 - $55,000 per year (depending on experience)Job ResponsibilitiesThe successful...
-
Senior Care Companion
4 weeks ago
Salem, Oregon, United States Senior Helpers - Salem Full timeAbout Senior Helpers - SalemWe are a leading provider of in-home senior care services, dedicated to enhancing the lives of our clients.As a trusted partner in senior care, we offer specialized support for individuals with chronic diseases, as well as companion services for those seeking assistance with daily activities.Job Title: Personal Care...
-
Senior Care Clinical Manager
3 weeks ago
Winston-Salem, North Carolina, United States Sunrise Senior Living Full timeSunrise Senior Living**Job Overview:** We are seeking a highly skilled and experienced Clinical Manager to lead our nursing team in providing exceptional care to our residents. As a Clinical Manager, you will be responsible for overseeing the health and wellness of our residents, managing the nursing team, and ensuring compliance with regulatory...
-
Senior Care Director
2 weeks ago
Winston-Salem, North Carolina, United States Sunrise Senior Living Full timeAbout the RoleSunrise Senior Living is seeking a motivated and experienced Nursing Director to lead our clinical team in providing high-quality care to our residents. This role is responsible for overseeing the health and wellness of our residents, managing the nursing staff, and ensuring compliance with regulatory requirements.
-
Senior Rehabilitation Therapist Opportunities
2 weeks ago
Salem, Indiana, United States American Senior Communities Full timeAre you a dedicated professional looking to make a difference in the lives of seniors?American Senior Communities is seeking a qualified Speech Language Pathologist to join our team.About the Job:As a Speech Language Pathologist with American Senior Communities, you will have the opportunity to work with a diverse population of seniors and provide...
-
Senior Staff Product Compliance Engineer
6 days ago
Salem, United States Agility Robotics Full timeJob DescriptionJob DescriptionAgility Robotics is a pioneer. Our robot, Digit, is the first to be sold into workplaces across the globe. Our team is differentiated by its expertise in imagining, engineering, and delivering robots with advanced mobility, dexterity, intelligence, and efficiency -- robots specifically designed to work alongside people, in...
-
Senior Staff Product Compliance Engineer
4 days ago
Salem, United States Industrialinnovationfund Full timeAgility Robotics is a pioneer. Our robot, Digit, is the first to be sold into workplaces across the globe. Our team is differentiated by its expertise in imagining, engineering, and delivering robots with advanced mobility, dexterity, intelligence, and efficiency -- robots specifically designed to work alongside people, in spaces built for people. Every day,...
-
Senior Maintenance Operations Manager
2 months ago
Salem, Oregon, United States Bonaventure Senior Living Full timeJob DescriptionBonaventure Senior Living is seeking a skilled Senior Maintenance Operations Manager to oversee the maintenance and upkeep of our senior living properties.About the RoleThis is an exciting opportunity for a seasoned professional with a passion for delivering exceptional customer service and ensuring seamless day-to-day operations.In this role,...
-
Senior Support Specialist
2 weeks ago
Salem, Oregon, United States Senior Helpers - Salem Full timeCaregiver and Companion Job DescriptionSenior Helpers - Salem is committed to providing exceptional in-home care services, and we're looking for a compassionate Caregiver and Companion to join our team.Estimated Salary: $17 per hourAbout the RoleDeliver high-quality care and support to seniors in their homes, focusing on their physical, emotional, and social...
-
Medication Assistant
2 weeks ago
Salem, Oregon, United States ONELIFE Senior Living Full timeAbout the RoleWe are looking for a reliable and empathetic Medication Assistant - Senior Living to assist our residents with medication administration and provide top-notch care. As a member of our team, you will have the opportunity to make a real difference in the lives of our seniors.Key ResponsibilitiesAdministering medications as per individual care...
-
Senior Living Healthcare Leader
4 weeks ago
Winston-Salem, North Carolina, United States Sunrise Senior Living Full timeAbout the RoleAs a Senior Living Healthcare Leader at Sunrise Senior Living, you will have the opportunity to champion quality of life for seniors and their families.Job DescriptionNursing Clinical Leadership: Provide strategic leadership for resident care in the community, managing and directing the nursing team to promote health and wellness.Clinical Care...
-
Care Professional
3 weeks ago
Salem, Indiana, United States American Senior Communities Full timeJoin Our Team:We are seeking a dedicated Speech Language Pathologist to join our team at American Senior Communities. As a member of our staff, you will have the opportunity to make a meaningful difference in the lives of our residents and their families.Responsibilities:* Provide skilled speech-language services to patients in our senior living communities*...
-
Culinary Expert
2 weeks ago
Salem, Oregon, United States ONELIFE Senior Living Full timeCulinary Expert Role in a Dynamic EnvironmentWe are seeking a skilled Culinary Expert to join our team at ONELIFE Senior Living. As a crucial member of our kitchen staff, you will have the opportunity to create delicious and nutritious meals for our senior residents.Our community values a supportive and professional work culture that encourages growth and...
-
Senior Health Professional
1 day ago
Winston-Salem, North Carolina, United States CenterWell Senior Primary Care Full timeKey Responsibilities: Deliver exceptional patient care through comprehensive health assessments, diagnosis, and treatment plansCollaborate with interdisciplinary teams to coordinate patient care and develop effective treatment strategiesMaintain accurate and up-to-date patient records, ensuring compliance with regulatory requirementsRequirements: Bachelor's...
-
Senior Accounting Professional
2 weeks ago
Salem, Oregon, United States CV Resources Full timeCV Resources is partnering with a rapidly growing health and wellness company to find a skilled Senior Staff Accountant. This innovative company focuses on making a positive impact in its sector.Position OverviewThe successful candidate will play a critical role in the monthly close process, financial reporting, account reconciliations, and ensuring...