Compliance Fellow

Humana

Olympia, WA(remote)

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JOB DETAILS

SALARY

$203,400–$279,800 Per Year

SKILLS

Actuarial Skills, Affirmative Action, Analysis Skills, Business Operations, Business Skills, Cable Modem, Centers for Medicare and Medicaid Services (CMS), Content Management Systems (CMS), Customer Experience, DSL (Digital Subscriber Line), Financial Operations, Genetics, Government, Government Policies, HIPAA (Health Insurance Portability and Accountability Act), Healthcare, Insurance, Leadership, Managed Care, Medicaid, Medicare, Military, Policy Evaluation, Program Evaluation, Public Affairs, Public Policy, Regulatory Compliance, Rehabilitation Act, Requirements Validation/Verification, Risk, Risk Analysis, Team Lead/Manager, Willing to Travel, Work From Home

LOCATION

Olympia, WA

POSTED

4 days ago

**Become a part of our caring community** The Compliance Fellow ensures compliance with governmental requirements. The Compliance Fellow contributes through a combination of (a) necessary technical expertise and (b) technical/process leadership that provides functional guidance to professional associates. Apply advanced in-depth and broad knowledge and considered top "go to" resource in their field. Humana must improve its advocacy work on future risk adjustment methodology to support the long-term success and financial viability of the Medicare Advantage program. The Risk Adjustment Compliance Fellow will lead horizontal teams throughout the Risk Adjustment organization. These teams will also include members from Actuarial, Government Affairs, and the Clinical organizations. The Fellow will create engagement to evaluate risk adjustment policies and program changes proposed by CMS. You will also be an expert. This expert will increase proactive evaluations of risk adjustment program policies and industry ideas. These evaluations will inform Humana's Government affairs and public policy team, along with senior leaders at Humana, of how proposed policies may improve Humana's insurance segment. More importantly, they will inform them of the impact on customer experiences and outcomes. Also, the Risk adjustment Compliance Fellow will increase creative idea generation when considering the possibilities that CMS's Medicare Advantage Risk Adjustment program will undergo regarding future changes. You will be an important advisor to several senior leaders at Humana, including the President of Insurance, SVP of Risk Adjustment, and Humana's Chief Actuary. These leaders also include the VP of Public Policy. You will allow Humana to position themselves as an industry leader in influencing future Risk Adjustment policy and methodology through industry channels. The Risk Adjustment Compliance Fellow will to prepare Humana for future Risk Adjustment changes to minimize impact to customer experiences and outcomes. You will report to Associate VP, Risk Adjustment and be a part of the Risk Adjustment team. **Detailed responsibilities will include:** + Work within broad goals to evaluate and propose risk adjustment program policies and to communicate impacts to the enterprise's financial and business operations + Inform and influence senior leaders on evaluation and influence of risk adjustment policies and methodologies while considering approach to influence industry to shape future risk adjustment policy + Introduce solutions to complex risk adjustment problems that has impact on Humana's insurance segment and future risk adjustment policy + Lead Humana to become a stronger in the industry to support future risk adjustment policy **Required Skills:** + Experience assembling and leading team members + Experience leading complex work and problems that are typically undefined but that have substantial and long-term impact on the insurance segment + Experience navigating complex issues and exercising + Apply to influence future risk adjustment policy and methodology through partnership with Government affairs and public policy team + Exercise independent to grow overall future risk adjustment policy + Executive-level **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree with at least 15 years of related experience + 10+ years of project/people leadership + Previous experience influencing policy and industry bodies + Experience with Medicare Advantage bid process + Medicare Risk Adjustment Knowledge + Expert known outside of Humana for involvement in supporting Humana regulatory/compliance-focused work + Strategic business acumen + Knowledge of the healthcare environment and managed care. · **Preferred Qualifications** + Strong analytical background + Experience in previous compliance, policy, or government affairs teams + Experience working with CMS **Additional Information** **Work-At-Home Requirements** + WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. + A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. + Satellite and Wireless Internet service is NOT allowed for this role. + 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. $203,400 - $279,800 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. Application Deadline: 05-29-2026 **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. 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.

About the Company

Humana

INDUSTRY

Other/Not Classified