Description
The Compliance & Contract Audit Lead is responsible for oversight of the Contractor’s risk management process. The position shall analyze operations and critically assess compliance with all requirements.Responsibilities
Position Responsibilities:
Coordinates the preparation and execution of Contract documents, audits, and ad hoc visits
Audits records of Contract agreements in which the organization is involved
Prepares reports for management on the results of audits, providing recommendations on improvements
Works with finance to estimate the potential financial consequences of an occurring loss
Assesses and communicates information regarding business risks with functions across the organization
Works closely with internal and external auditors, financial investigators, and claims processing areas
Advises executives to develop functional strategies on matters of significance
Uses independent judgment requiring analysis of variable factors and determines the best course of action.
Required Qualifications
Bachelor’s degree in related field
5+ years’ of experience in auditing, consulting, or compliance-related field
Experience working with regulatory agencies, including state departments of health insurance or CMS
Knowledgeable in process improvement and metrics development and in regulations governing healthcare industries
Strong communication skills
Must reside in the state of Oklahoma, preferably Oklahoma City metro area
Preferred Qualifications
Advanced graduate degree
Certifications, such as: JD, CPA, CIA, CISA, CISSP, or PMP
3+ years’ of experience in health plan operations
Leadership experience
Additional Information
Our Benefits
Health benefits effective day 1. Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:
- Paid time off, holidays, volunteer time and jury duty pay, Recognition pay.
- 401(k) retirement savings plan with employer match.
- Tuition assistance, Scholarships for eligible dependents.
- Parental and caregiver leave.
- Employee charity matching program.
- Network Resource Groups (NRGs).
- Career development opportunities.
Work at Home Criteria
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 recommended; wireless, wired cable or DSL connection is suggested.
- Satellite, cellular and microwave connection can be used only if approved by leadership.
- Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
- Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Interview Format
As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
Scheduled Weekly Hours
40More Information
Application Details
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Organization Details
004 Humana Insurance Company
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