Compliance Lead

HumanPanorama

Base: $115,200 - $158,400 py; bonus: eligible for ...
Fully remote
Medicare part c clinical utilization management
Federal and state regulatory compliance
Prior authorization and quality of care programs
The Compliance Lead ensures adherence to governmental requirements and contract obligations for the Medicare Part C line of business

Job Summary

  • The Compliance Lead ensures adherence to governmental requirements and contract obligations for the Medicare Part C line of business.
  • This role involves developing audit methodologies, leading onsite program audits, and providing strategic guidance to executives on complex compliance issues.
  • Humana offers competitive benefits including medical, dental, vision, 401(k) retirement savings, and a bonus incentive plan based on performance.

Matching Summary

The Compliance Lead ensures adherence to governmental requirements and contract obligations for the Medicare Part C line of business.

Salary

Base: $115,200 - $158,400 per year; Bonus: Eligible for company/individual performance incentive plan; Benefits: Medical, dental, vision, 401(k), paid time off, disability, life insurance

Skills & Requirements

Must-have

  • Medicare Part C Clinical Utilization Management
  • Federal and State Regulatory Compliance
  • Prior Authorization and Quality of Care Programs
  • Audit Methodology Development and Execution
  • 8+ Years Compliance or Audit Experience

Nice-to-have

  • Passion for improving consumer experiences
  • Project Management Professional (PMP) certification
  • Six Sigma certification
  • Leadership experience in compliance committees
  • Advanced graduate degree in relevant field

Key Requirements

  • Bachelor's Degree required
  • 8 or more years of compliance or audit related experience
  • Experience with Medicare Part C Clinical Utilization Mgt
  • Advanced data validation and communication skills

Work Rights

Not specified

Tailored Resume

Cover Letter