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Humana is seeking a Compliance Professional 2 to support Medicare and Medicaid compliance activities with a primary focus on Payment Integrity financial recovery processes. This role is responsible for helping ensure adherence to regulatory, contractual, and internal requirements through proactive monitoring, reporting, and collaboration across business areas.
Compliance Professional 2 will serve as a liaison to CAPI business areas and other cross-functional partners to promote clear communication, effective oversight, and operational consistency.
Success in this role requires strong attention to detail, timely execution, sound judgment, and working knowledge of Medicare and Medicaid requirements. This position also supports continuous improvement efforts, including identifying and assisting with automation opportunities that enhance compliance monitoring and reporting.
Where you Come In
This role supports Humana’s strategic initiative of enhancing the Payment Integrity Compliance framework with a focus on financial recovery related processes. The addition of a Compliance Professional 2 is essential for ensuring effective compliance monitoring, process improvement, operational efficiency, and risk mitigation.
Success in this role requires timely execution, strong attention to detail, and familiarity with the Medicare and Medicaid lines of business.
Key Duties and Responsibilities
- Support Medicare and Medicaid compliance activities related to Payment Integrity, with a primary focus on financial recovery processes.
- Monitor business operations to ensure compliance with applicable regulatory, contractual, and internal requirements.
- Proactively identify potential or actual incidents of noncompliance and coordinate timely mitigation and follow-up activities.
- Perform compliance reviews, monitoring, and reporting to help ensure accuracy, timeliness, and operational consistency.
- Serve as a liaison between Compliance and CAPI business partners to support effective communication, issue resolution, and adherence to requirements.
- Analyze compliance-related data, trends, and process outcomes to identify gaps, risks, and opportunities for improvement.
- Support corrective action planning and remediation efforts in partnership with cross-functional teams.
- Maintain documentation, reporting, and audit-ready support materials related to compliance monitoring activities.
- Assist in the development, enhancement, and ongoing execution of the Payment Integrity Compliance framework.
- Identify and support process improvement and automation opportunities that strengthen compliance oversight and operational efficiency.
- Manage assigned projects and deliverables, ensuring work is completed accurately, timely, and in alignment with business priorities.
- Provide team support and coverage, as needed, to help maintain continuity of compliance monitoring and financial recovery operations.
Use your skills to make an impact
Required Qualifications
- Minimum of 2 years of experience in compliance or with Medicare and Medicaid federal regulations
- Payment Integrity experience
- Experience managing project-based work
- Intermediate proficiency in Microsoft Word and Excel
- Strong analytical, organizational, and communication skills
- Must be located within the contiguous United States based on Medicare and Medicaid requirements
Preferred Qualifications
- Knowledge of Humana’s Payment Integrity Financial Recovery business teams and processes
- Experience creating and managing dashboards for compliance monitoring and reporting
- Experience performing advanced data manipulation and analysis
- Proficiency using pivot tables and related Excel reporting tools
Work Style: This is a fully remote position, applicants must live in the contiguous United States. Occasional travel to Humana's offices for training or meetings may be required.
Work Hours: Typical business hours are Monday-Friday 40 hours per week (start as early as 6am, no later than 9am; some flexibility might be possible, depending on business needs.
Interview Format: As part of our hiring process, we will be using on-demand technology provided by Hire Vue, a third-party vendor. This technology provides our team of recruiters and hiring managers with an enhanced method for decision-making through on-demand candidate assessments.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in an on-demand assessment with pre-determined questions. You should anticipate the assessment to take approximately 10-15 minutes.
Your on-demand assessment will be reviewed, and you will subsequently be informed if you will be moving forward to the next round of interviews.
SSN Task via Workday: Should you receive a formal employment offer, you will receive a request to enter your SSN into our Workday system to scan for duplicate profiles.
Reporting Structure: The Compliance Professional 2 reports to the Manager, Compliance
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
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.
$65,000 - $88,600 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 10-31-2026
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.
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.
