Job Details
IFG - Senior Compliance Professional
**Become a part of our caring community and help us put health first**
The IFG Senior Compliance Professional ensures compliance with Health Plan contracts and 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.
**We are currently seeking a Compliance Representative for a limited term position that is expected to be 3-9 months, but exact length is TBD.**
The IFG Senior Compliance Professional ensures compliance with Health Plan contracts and 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.
We are looking for an experienced Senior Compliance Professional specializing in Medicare Advantage to join our Field Marketing Organization (FMO). This role is pivotal in ensuring that our organization and partners comply with all applicable regulations and contracts while also supporting our growth initiatives within this segment. 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 Senior Compliance Professional monitors and overseas insurance agents and agencies for compliance of policy and procedures and federal and states regulations.
**Typical responsibilities will include:**
+ Research and investigate allegations of agent/agency misconduct and assign the appropriate corrective action, based on a review of relevant documentation for Internal agents.
+ Analyze, identify and report trends generating agent-related complaints to include CTMs and take actions to reduce CTMs and complaints.
+ Identify solutions to systemic problems identified
+ Demonstrate an understanding of Medicare regulations and an ability to apply the regulations
+ Respond to interdepartmental inquiries
+ Coordinate and maintain relationships with partner agents and agencies.
+ Makes decisions on moderately complex to complex issues regarding technical approach for assignments, and work is performed with minimal direction.
+ Handle urgent sensitive work in an expeditious manner
+ Monitor changes in Medicare regulations and policies, providing insights and recommendations to leadership and internal teams.
+ Conduct compliance audits and assessments to identify risks and areas for improvement, implementing corrective actions as necessary.
+ Collaborate with cross-functional teams, including marketing, operations, and sales, to ensure compliance is integrated into all aspects of Medicare Advantage initiatives.
+ Develop and deliver agency and agent training on compliance requirements, best practices, and regulatory changes.
+ Review marketing materials and communications to ensure compliance with CMS guidelines and company policies.
+ Prepare and maintain documentation for compliance activities, including reports, training materials, and audit findings.
+ Participate in the development of policies and procedures to enhance compliance operations and risk management.
**Use your skills to make an impact**
**Required Qualifications**
+ **This is a limited term position that is expected to be 3-9 months, but exact length is TBD.**
+ Minimum of 3 years of experience in compliance within the insurance industry, with a focus on Medicare Advantage.
+ Strong understanding of Medicare regulations, CMS guidelines, and compliance best practices.
+ Excellent analytical skills with the ability to assess complex regulatory requirements and develop actionable strategies.
+ Strong communication and interpersonal skills to effectively collaborate with various stakeholders.
+ Proven ability to work independently and manage multiple priorities in a fast-paced environment.
+ Minimum of 1 year Audit or consulting experience
+ Experience with metric monitoring and reporting
**Preferred Qualifications**
+ Bachelor's degree in Business, Finance, Law, Healthcare Administration, or a related field
+ Advanced degree
+ Compliance certification e.g. CHC
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.
$86,300 - $118,700 per year
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident.
Application Deadline: 07-17-2025
**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 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.
The IFG Senior Compliance Professional ensures compliance with Health Plan contracts and 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.
**We are currently seeking a Compliance Representative for a limited term position that is expected to be 3-9 months, but exact length is TBD.**
The IFG Senior Compliance Professional ensures compliance with Health Plan contracts and 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.
We are looking for an experienced Senior Compliance Professional specializing in Medicare Advantage to join our Field Marketing Organization (FMO). This role is pivotal in ensuring that our organization and partners comply with all applicable regulations and contracts while also supporting our growth initiatives within this segment. 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 Senior Compliance Professional monitors and overseas insurance agents and agencies for compliance of policy and procedures and federal and states regulations.
**Typical responsibilities will include:**
+ Research and investigate allegations of agent/agency misconduct and assign the appropriate corrective action, based on a review of relevant documentation for Internal agents.
+ Analyze, identify and report trends generating agent-related complaints to include CTMs and take actions to reduce CTMs and complaints.
+ Identify solutions to systemic problems identified
+ Demonstrate an understanding of Medicare regulations and an ability to apply the regulations
+ Respond to interdepartmental inquiries
+ Coordinate and maintain relationships with partner agents and agencies.
+ Makes decisions on moderately complex to complex issues regarding technical approach for assignments, and work is performed with minimal direction.
+ Handle urgent sensitive work in an expeditious manner
+ Monitor changes in Medicare regulations and policies, providing insights and recommendations to leadership and internal teams.
+ Conduct compliance audits and assessments to identify risks and areas for improvement, implementing corrective actions as necessary.
+ Collaborate with cross-functional teams, including marketing, operations, and sales, to ensure compliance is integrated into all aspects of Medicare Advantage initiatives.
+ Develop and deliver agency and agent training on compliance requirements, best practices, and regulatory changes.
+ Review marketing materials and communications to ensure compliance with CMS guidelines and company policies.
+ Prepare and maintain documentation for compliance activities, including reports, training materials, and audit findings.
+ Participate in the development of policies and procedures to enhance compliance operations and risk management.
**Use your skills to make an impact**
**Required Qualifications**
+ **This is a limited term position that is expected to be 3-9 months, but exact length is TBD.**
+ Minimum of 3 years of experience in compliance within the insurance industry, with a focus on Medicare Advantage.
+ Strong understanding of Medicare regulations, CMS guidelines, and compliance best practices.
+ Excellent analytical skills with the ability to assess complex regulatory requirements and develop actionable strategies.
+ Strong communication and interpersonal skills to effectively collaborate with various stakeholders.
+ Proven ability to work independently and manage multiple priorities in a fast-paced environment.
+ Minimum of 1 year Audit or consulting experience
+ Experience with metric monitoring and reporting
**Preferred Qualifications**
+ Bachelor's degree in Business, Finance, Law, Healthcare Administration, or a related field
+ Advanced degree
+ Compliance certification e.g. CHC
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.
$86,300 - $118,700 per year
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident.
Application Deadline: 07-17-2025
**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 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.
Job #NLX278926131