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Senior Insurance Product Compliance Professional

Key Facts

Remote From: 
Full time
Senior (5-10 years)
English

Other Skills

  • Ability To Meet Deadlines
  • Decision Making
  • Social Skills
  • Adaptability
  • Collaboration

Roles & Responsibilities

  • 3+ years of experience with Medicare Advantage and/or Medicaid compliance
  • Ability to summarize complex information and tailor communication based on audience
  • Ability to work independently while managing deliverables
  • Ability to affect change in a highly matrixed organization

Requirements:

  • Research and analyze rules, regulations, and sub-regulatory guidance for insurance products
  • Assess risk and consult on licensure or corporate structure
  • Draft, file, and negotiate approval with state and federal regulators for service area expansions
  • Prepare product-specific documents, contracts, licenses, and marketing materials

Job description

Become a part of our caring community
 

The Senior Insurance Product Compliance Professional researches and analyzes rules, regulations, and sub-regulatory guidance. These guidelines apply to insurance products, such as Medicare Advantage, Part D, Group Specialty, and Individual Specialty. Additionally, you will assess risk and consult on licensure or corporate structure.

The Senior Insurance Product Compliance Professional partners with internal stakeholders and serves as a Humana liaison. You will draft, file, and negotiate approval with state and federal regulators for service area expansions. Additionally, you will prepare product-specific documents, contracts, licenses, member communications, or marketing materials. Throughout these tasks, you will safeguard Humana's brand and support the implementation and maintenance of compliant insurance products in collaboration with responsible business owners.


Use your skills to make an impact
 

Required Qualifications

  • 3+ years of experience with Medicare Advantage and/or Medicaid compliance

  • Ability to summarize complex information and tailor communication based on audience (i.e., contracts, federal and state regulations)

  • Ability to work independently while maintaining focus and managing deliverables to meet critical internal and external deadlines

  • Ability to affect change in a highly matrixed organization, leveraging data and facts to influence decision-makers

Preferred Qualifications

  • Experience working with State Agencies

  • Understanding of State and Federal Regulations

  • Experience specific to Dual Eligible members and healthcare plans for MA DSNP product offerings

  • Knowledge of Humana's internal policies, procedures, and systems

Work at Home Requirements
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary.

Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

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.


 

$78,400 - $107,800 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 07-06-2026


About us
 

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.


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.

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