Compliance Professional - Investigations and Corrective Actions

Compliance Professional - Investigations and Corrective Actions

Location: Remote, Nationwide

Remote Job: Remote Job: Yes

widget: Full time

Category: Corporate

Humana

Job ID: R-430275

Description

• Become a part of our caring community

• With over 10 million sales interactions annually, Humana understands that while great products are important, it’s the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does.

• The Compliance Professional supports Humana’s compliance program by conducting sales and/or marketing investigations, issuing corrective actions, performing quality assurance (QA) reviews, and assisting with monitoring activities. Work assignments are routine to moderately complex, requiring application of established compliance principles, policies, and regulatory standards with guidance from senior compliance professionals.

Responsibilities

• Conduct routine and moderately complex compliance investigations following established procedures.

• Issue associated corrective actions based on investigation results.

• Collect documentation, conduct interviews, and summarize investigative findings.

• Maintain complete, accurate investigation files and case documentation.

• Escalate high‑risk or complex issues to senior compliance leadership.

• Support corrective action planning and follow‑up activities.

• Perform QA reviews of investigations, monitoring activities, and compliance documentation.

• Identify errors, inconsistencies, and procedural gaps.

• Document QA outcomes and assist with trend analysis and reporting.

• Track corrective actions and validate closure.

• Use your skills to make an impact

• Required Qualifications

• Bachelor's degree or equivalent experience

• 2 to 5 years of compliance, investigations, audit, or regulatory experience.

• Ability to manage multiple or competing priorities and meet deadlines

• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

• Strong attention to detail

• Preferred Qualifications

• Bilingual (Spanish)

• Compliance regulations experience

• Prior sales agent

• 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.

• $65,000 - $88,600 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.

• 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.

• We Love our jobs, you should too.

• Employment Fraud Notice

• Humana will never ask a candidate for money for work equipment and network access or request access to personal accounts during the application process. Learn more about identifying and preventing employment fraud or report a suspected employment fraud case.

• Applicant Privacy Policy

• Review how we collect and use applicant information in our Applicant Privacy Policy.

• Labor Notices

• Review our federal, state, and local labor notices on our Legal Information page.

• Card link

• Card text

• At Humana, caring is everything

• And when you work here, you feel it. It’s how you grow. It’s how you’re welcomed into the associate community. It’s what guides us in helping people acheive their best health. And it forms the connection each of us have for the people we serve.

• Get notified for similar jobs

• Sign up to receive job alerts

• Currently we don't have any jobs that fit your interests.

• Similar jobs

• Senior Process Improvement Professional

• Location: Remote, Nationwide

• Remote Job: Yes

• widget: Full time

• Category: Corporate

• undefined: Humana

• Job ID: R-431748

• Senior Compliance Professional, Medicaid

• Location: Remote, Nationwide

• Remote Job: Yes

• widget: Full time

• Category: Corporate

• undefined: Humana

• Job ID: R-431464

• Home Health Facility Licensure & Regulatory Compliance Analyst

• Location: Remote, Nationwide

• Remote Job: Yes

• widget: Full time

• Category: Corporate

• undefined: OneHome

• Job ID: R-423867

• View More

• Life at Humana

• We’re working together to build strong communities inside and outside.

• Link

• Culture

• We’re working together to build strong communities inside and outside.

Benefits

• Company sees the whole person and looks to support your well-being.

• Diversity and Inclusion

• We value individuality. experiences that have shaped your world.

• A sense of mutual respect and mindfulness permeates our culture-in fact, it’s the key to our success.

• Learn more