Compliance Professional -medicaid

CarePlus Health Plans Inc

Glen Allen, VA, US
Base: $65,000 - $88,600 py; bonus: eligible for in...
Hybrid
Medicaid regulatory compliance experience
Critical incident reporting to regulators
Audit request review and monitoring
CarePlus Health Plans Inc. is seeking a Compliance Professional to join their Humana Healthy Horizons team in Virginia. This hybrid position involves managing regulatory inquiries, coordinating responses, and ensuring compliance with healthcare regulations, particularly concerning Medicaid and Medicare

Job Summary

  • The role involves assisting with incoming regulatory inquiries and coordinating responses for State and Federal agencies such as CMS.
  • Candidates will be responsible for monthly, quarterly, and annual Critical Incident reporting to the regulator while reviewing audit requests.
  • Humana offers competitive benefits including medical, dental, vision, 401(k) retirement savings, and paid time off.

Matching Summary

Match Score: 85

CarePlus Health Plans Inc. is seeking a Compliance Professional to join their Humana Healthy Horizons team in Virginia. This hybrid position involves managing regulatory inquiries, coordinating responses, and ensuring compliance with healthcare regulations, particularly concerning Medicaid and Medicare.

Salary

Base: $65,000 - $88,600 per year; Bonus: Eligible for incentive plan based on performance; Benefits: Medical, dental, vision, 401(k), paid time off

Skills & Requirements

Must-have

  • Medicaid regulatory compliance experience
  • Critical incident reporting to regulators
  • Audit request review and monitoring
  • State and federal agency interaction
  • Corrective action plan monitoring

Nice-to-have

  • Influence department strategy through recommendations
  • Collaboration with subject matter experts
  • Knowledge of Humana cultural values
  • Experience with internal and external audits

Key Requirements

  • Bachelor's or associate degree required
  • 2-5 years healthcare or managed care experience
  • 2 years auditing, risk, or compliance experience
  • Must reside in Virginia or within 40-mile radius
  • Regulatory or Medicare/Medicaid compliance experience

Work Rights

Not specified

Tailored Resume

Cover Letter