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The Senior Risk Management Professional role with the Contract Management Unit, part of Retail Operational Risk Management team, will be responsible for meticulously reviewing regulatory changes and new rules pertinent to the Medicaid line of business. Your primary focus will be to identify requirements and assess potential impacts on various business areas.

Location: remote

The Senior Risk Management Professional role with the Contract Management Unit, will be responsible for meticulously reviewing regulatory changes and new rules pertinent to the Medicaid line of business. Your primary focus will be to identify requirements and assess potential impacts on various business areas. By collaborating closely with these areas, you will ensure alignment on the interpretation of regulations and facilitate the necessary actions to achieve compliance.

This role requires strong analytical skills, attention to detail, and the ability to work effectively with cross-functional teams to maintain the highest standards of regulatory adherence. Your expertise will be crucial in navigating the complexities of Medicaid regulations and ensuring our operations remain compliant and efficient.

Role Responsibilities ​ ​

• Review and analyze new regulations and contract requirements to identify applicable regulatory obligations.

• Summarize and communicate key regulatory requirements to relevant stakeholders within the organization.

• Collaborate with business partners to seamlessly integrate regulatory changes into business processes.

• Monitor and audit the implementation of regulatory requirements to verify adherence and effectiveness.

• Supports Humana’s reputation as a trustworthy and reliable healthcare provider.

• Provides ongoing training and support to ensure teams understand and execute compliance measures properly.

Use your skills to make an impact

Required Qualifications

• Bachelor’s degree or equivalent work experience

• 5 years or more years of experience in Medicare, Medicaid, risk management and/or legislative/regulatory guidance

• Project leadership experience and demonstrated ability to influence cross-functional team deliveries

• Excellent analytical and problem-solving skills

• Excellent communication skills, both oral and written

• Proven ability to manage multiple tasks, projects, and deadlines in a fast-paced environment

• Proficient with Microsoft Office; Excel, Outlook, PowerPoint, and Word

Preferred Qualifications

• Advanced degree

• Understanding of Corporate Policies & Procedures

• Experience with Enterprise Solution Point (ESP)

Additional Information

You will report to the Associate Director of Operational Risk Management. This area is under the leadership of the Retail Segment President.

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.

$76,800 - $105,800 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. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

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 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. 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.