Humana Compliance Risk Advisor in Louisville, Kentucky

Role: Compliance Risk Advisor Assignment: Compliance, Medicare Location: Louisville, Kentucky

Healthcare isn’t just about health anymore. It’s about caring for family, friends, finances, and personal life goals. It’s about living life fully. At Humana, we want to help people everywhere, including our associates, lead their best lives. We support our associates to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our associates fresh perspective, new insights, and exciting opportunities to grow their careers. At Humana, we’re seeking innovative people who want to make positive changes in their lives, the lives of our members, and the healthcare industry as a whole.

Assignment Capsule

Humana is seeking a Compliance Risk Advisor to provide guidance and help enhance and oversee the compliance program related to Medicare risk adjustment to minimize compliance risk exposure to the company * Work closely with market and/or operations leadership to provide risk assessment of the current and proposed business activities related to Medicare risk adjustment

  • Oversee enterprise efforts to strengthen compliance controls to minimize fraud, waste, and abuse

  • Lead and participate in market and corporate team meetings and committees, providing compliance guidance and direction

  • Serve as subject matter expert on state and federal regulations and to market, corporate, healthcare delivery, managed service organization associates including presentations on changes and updates in laws and regulations

  • Review business processes to ensure compliance with laws and regulations and enterprise policies and procedures

  • Receive, investigate and respond to internal compliance issues and local, state and federal regulatory grievances, complaints and inquiries

  • Oversee activities related to regulatory audits

    Role Essentials

  • Bachelor’s Degree

  • Strong written and verbal communication skills

  • Advanced research, problem-solving, analytical and negotiation skills

  • Possess the capacity to maintain confidentiality and work independently

  • Are self-motivated and possess the ability to manage multiple priorities and work under pressure to meet deadlines

  • Strong PC skills including web enabled technologies such as internet based applications; Microsoft Word, Excel, PowerPoint

  • Ability to quickly develop strong professional working relationships internally and externally

  • Previous compliance or audit experience Role Desirables

  • Juris Doctor from accredited law school

  • Have prior experience and knowledge about Medicare Advantage and risk adjustment

  • Have prior background working in a compliance related area

  • Knowledge of the healthcare insurance industry

  • Prior work experience with project management

  • Experience interacting with governmental agencies

Additional Information

At Humana, we’re also committed to making the resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. We know your well-being is important to you, and it’s important to us too. If you share our passion for helping people, we likely have the right place for you at Humana.

After applying, we encourage you to join our Talent Network as well, so you can stay informed and up to date on what’s happening around our organization in the changing world of healthcare.

Title: Compliance Risk Advisor

Location: KY-Louisville

Requisition ID: 178122