Senior LVN/RN Compliance Professional West region located in the i.e. CA AZ NV WA

Profile

Description

The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

Seeking Senior LVN/RN Compliance Professional to develop and maintain key relationships by working with internal and external business partners to evaluate and maintain compliance.


Efficiently track, report, and communicate all audit information to delegates and required internal departments.
Review and analyze the delegates' policies and procedures as well as claims files to ensure they are compliant with regulatory and legislative requirements
Issue corrective action plans as applicable. Work with the assigned delegates until the issue has been resolved.
Develop and maintain key relationships with the assigned delegates to optimize business results.
Assist in special projects that promote department efficiency.


Required Qualifications


Active LVN/RN License without restriction in state of licensure
Ability to effectively represent Humana, with a high level of professionalism, when working with external delegates
Proficient knowledge of MS Word, Excel and PowerPoint
Knowledge/understanding of regulatory and legislative requirements
Excellent communication skills, both oral and written
Ability to work independently under general instructions and with a team
Ability to travel 20% (one to two times per month, travel is planned)


Preferred Qualifications


Auditing or consulting experience
Project coordination or management experience
Metrics and report development experience
Vendor management experience
Knowledge/understanding of claims and/or delegation laws, regulations and accreditation requirements


Additional Information:

This role is located in the West region,(i.e. CA, AZ, NV, WA)

Scheduled Weekly Hours

40

Company info

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