Compliance specialist Jobs in Honolulu, HI

Become a part of our caring community and help us put health first

This role has ownership for securing and overseeing implementation of Humana's Dual Eligible Special Needs Plan (D-SNP) State Medicaid Agency Contracts (SMACs) annually as well as securing contracts in new states to support Humana's sales and membership growth initiatives. This entails :

• Has 4 direct reports and 8 indirect reports
• Negotiates SMACs with state Medicaid agencies
• Ensures compliance cross-functionally across the enterprise with all contract elements and drives implementation efforts
• Engages with CMS Duals Office to influence regulatory guidance for D-SNPs
• Works with state and federal Government Affairs teams to develop comments on proposed regulatory changes to serve Humana's best interests
• Works with Medicaid and Medicare Organizations to stand up new integrated D-SNPs and assist with developing the future Integrated D-SNP Operating Model
• Assists teams across the enterprise to explain contractual requirements / regulatory guidelines in order to drive compliant internal processes
• Completes all necessary application, MOC and SMAC filing requirements with CMS to ensure Humana's is compliantly positioned to operate D-SNPs in each state

Use your skills to make an impact

Required Qualifications

Preferred Qualifications

Additional Information

This position will have limited travel up to 10%-20% and will be on EST hours.

Scheduled Weekly Hours

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.

150,000 - $206,300 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.

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.

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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements.

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