Compliance Professional -Medicaid

Job description

Become a part of our caring community Humana Healthy Horizons in Virginia is seeking a Compliance Professional who will assist with incoming regulatory inquiries/requests, coordinates inquiry responses, coordinates site visits for State and Federal agencies, and monitors corrective action plans, if applicable. Research regulatory issues/requests and partners with subject matter experts to provide responses while obtaining the proper approvals. Offers opportunity to influence the departments strategy by recommending updates to department procedures. Receives inquiries/requests from state partners with Law, Risk, and Compliance subject matter experts to respond, and reviews the responses for accuracy and completeness. Interacts with other professionals throughout the enterprise on significant healthcare compliance topics. Assists with reviews of Critical Incidents to determine is designations and submissions are appropriate. Responsible for monthly, quarterly, and annual Critical Incident (CI) reporting to the regulator. Supports multiple external regulatory requests performed by state Departments of Insurance and Federal agencies, such as Health and Human Services' Centers for Medic...