Director, Compliance - Specialty and Military Products

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 The Director of Regulatory Compliance develops and implements compliance programs aimed at governmental requirements and regulations across Humana Specialty and Military products. The Director manages dedicated compliance teams of associates who oversee compliance programs in support of dental, vision, life, disability products, Medicare Supplement and other ancillary products as applicable. It also manages dedicated compliance associates who oversee compliance programs in support of Humana Government Business products such as TRICARE and other military contracts as applicable. The Director ensures that teams maintain annual risk assessments, auditing and monitoring work plans, oversight of corrective action plans, research compliance issues and provide compliance guidance to business partners, and promote strategies for compliance with contract obligations. The Director requires a solid understanding of how organization capabilities interrelate across department(s) in order to identify and address risk mitigation strategies. The role also requires strong communication skills and leadership skills. The Director maintains relationships with government agencies and other external auditors as applicable.

Humana is seeking a Director of Regulatory Compliance to develop and implement compliance programs for Humana’s Specialty and Military products and contracts.  The Director is responsible for compliance associates who are dedicated to compliance programs in support of dental, vision, life, disability, Medicare Supplement and other ancillary products as applicable to Medicare and Commercial segments.  It also responsible for dedicated compliance associates who implement and oversee compliance programs in support of Humana Government Business products such as TRICARE and other military contracts as applicable. The Director implements strategic plans, drives goals and objectives and improves performance.  The Director ensures that teams maintain annual risk assessments, auditing and monitoring work plans, oversight of corrective action plans, research compliance issues and provide compliance guidance to business partners, and promote strategies for compliance with regulatory and contract obligations. The teams are also responsible for analyzing business requirements, providing research and regulatory interpretation, and advising internal business units and external business partners in delivering results in a manner that minimizes compliance risk exposure for the Company.  Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes. The Director provides recommendations to compliance oversight committees in relation to risk mitigation and provides input into functions strategy.  As a Director, you will be part of a fast-growing team who develops and maintains key relationships both internally with Humana operational leaders as well as externally with our business partners. While working within assigned areas to optimize business results, you will:

• Develop strategy and provide ongoing oversight and monitoring of Specialty and Military products and contracts to promote compliance and minimize risk for the Enterprise;
• Direct the completion of annual risk assessments and work plans to audit and monitor performance across products and segments;
• Direct compliance teams to audit and monitor performance, report to leadership top risks, complete remediation plans and other information as appropriate;
• Direct compliance teams to review and analyze policies and process documents and data to identify what can be used to evidence meeting compliance and regulatory standards;
• Researches compliance issues and recommends changes that assure compliance with contract obligations. 
• Directs compliance teams in the interpretation of regulatory and contract requirements to be implemented by appropriate Humana Departments and/or external business partners;
• Work across Humana operational units and product lines to enhance data analytics and operational improvement efforts;
• Present at compliance oversight committee meetings as required and make recommendations to compliance oversight committees in relation to risk mitigation and remediation plans as needed;
• Build relationships with segment leadership and shared services business units;
• Communicate with and present to outside regulators as needed;
• Participate in external audits as needed, working with business partners and other compliance teams.

Use your skills to make an impact
 

Required Qualifications

• Bachelor’s degree
• 3 years of experience working in a Compliance-related, risk management and/or managed care-related field
• 2 years of management and/or leadership experience
• Strong communication skills with the ability to influence effectively
• Knowledgeable in regulations governing health care industries

Preferred Qualifications

• Juris Doctor or Masters of Business Administration, or other graduate degree
• Knowledgeable in compliance programs and processes 
• Experience working with regulatory agencies, including state departments of health insurance and/or CMS

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.

 

$150,000 - $206,300 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: 06-26-2025
About us
 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

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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.