Associate Director of Compliance - Agent Investigation Unit

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Job Information
Humana
Associate Director of Compliance - Agent Investigation Unit
in
Louisville
Kentucky
Description
The Associate Director, Compliance ensures compliance with governmental requirements. The Associate Director, Compliance requires a solid understanding of how organization capabilities interrelate across department(s).
Responsibilities
The Associate Director, Agent Investigations Unit (AIU) ensures allegations of potential non-compliant sales activity are managed and investigated effectively and efficiently. The Associate Director requires a solid understanding of sales processes and the laws and regulations that govern them. The Associate Director is responsible for setting the strategy and objectives for the AIU as well as ensuring adequate resources and tools are in place to meet those objectives. The Associate Director requires an in-depth understanding of how organization capabilities interrelate across the function or segment.
The Associate Director, AIU manages the day-to-day operations of the AIU to ensure allegations of non-compliant sales activity are handled and investigated in accordance with Humana policies and procedures.
Coordinates AIU operations across the internal Humana associates and offshore resources.
Ensures allegation inventory is monitored and managed effectively.
Collaborates effectively across other departments both within and outside the Compliance team. Oversees AIU systems and tools.
Decisions are typically related to the implementation of new/updated programs or large-scale projects of the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance.
Provides input into functions strategy.
Leads multiple managers or highly specialized professional associates.
Required Qualifications
Required Qualifications:
5 or more years of technical experience (e.g. compliance, healthcare investigations, legal, risk management)
3 or more years of management experience
Advanced experience working in compliance, risk management, healthcare investigations or managed-care field
Knowledgeable in regulations governing the healthcare industry
Strong communications skills with the ability to influence effectively
Strong understanding of process and workflow concepts
Inquisitive nature with ability to analyze data and metrics
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Bachelor's Degree
Advanced experience working in compliance, risk management, or managed-care field
Strong communication skills with the ability to influence effectively
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
MBA, Juris Doctor, or other graduate degree
Understanding of the regulations governing the sale and marketing of Humana plans
Experience leading teams of investigators
Experience managing offshore resources
Additional Information
Vaccine Policy:
Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field. Every associate and contractor who work inside a Humana facility or in the field, regardless of vaccination status, must complete a daily health-screening questionnaire.
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
Why Humana? You'll experience the following perks as a full-time Humana employee:
Compensation and Financial Security -
Our pay philosophy is designed to motivate and reward associates for their skills and contributions to the company. We provide options to help you plan for your future and protect your assets: Competitive base pay, Recognition pay, 401(k) retirement savings plan (125% match for the first 6% contributed by an associate), etc.
Your Whole Health -
Humana's health products and services are designed to encourage personal wellness and smart healthcare decisions for you and your family: Medical, dental, and vision benefits, Health plan incentives, Paternity leave, etc.
Work Perks -
Humana knows your life extends outside of work. We have many options to support your interests and needs. Some departments have the flexibility to allow associates to work from home, and we offer all associates: Paid time off, holidays, volunteer time, jury duty pay, Associate charity matching program, Discount programs with major retailers, etc.
Grow With Us -
Humana provides growth and career opportunities that can help you develop your skills and build your future with the organization: Internal and external learning events, Tuition assistance, Inclusion and diversity training, etc.
Social Security Task:
Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from **** with instructions to add the information into the application at Humana's secure website.
Interview Format:
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first round interview, you will receive an email correspondence inviting you to participate in a Modern Hire interview. In this interview, you will receive a set of interview questions over your phone and you will provide recorded or text message responses to each question. You should anticipate this interview to take about 15 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
More info on Why Humana.
Why Humana?
At Humana, we know your well-being is important to you, and it's important to us too. That's why we're committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. Just to name a few:
Work-Life Balance
Generous PTO package
Health benefits effective day 1
Annual Incentive Plan
401K - Immediate company match
Well-being program
Paid Volunteer Time Off
Student Loan Refinancing
If you share our passion for helping people, we likely have the right place for you at Humana.
COMPANY OVERVIEW
For more than 60 years, Humana has been a proven leader and innovator in the health and wellness industry. A passionate emphasis on people, choice, well-being, and innovation guide our business practices and culture. We're not just a health insurance company. Our diverse lines of business position us to serve millions of people with a wide range of needs, including seniors, military members, and self-employed individuals.
If you're looking for a career that provides opportunities for growth and development in a stable industry, Humana might be the right fit for you.
60 - We have been committed to seniors' health and care for nearly 60 years.
46K - We have 46,000 associates.
#56 - Ranked #56 on the Fortune 500 list in 2019.
16.6M - We have 16.6 million medical members across all 50 states.
12M - Since 2001, we have awarded more than $12 million in scholarships to children of Humana associates.
Scheduled Weekly Hours
40
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 ****

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