Senior Compliance Professional

Humana

. Implement new federal and state rules, including PBM rules, across the enterprise .

Posted 9/21/2026full-timeRemote • United StatesSenior💰 $86,300 - $118,700 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in healthcare compliance and regulatory implementations, with a strong focus on Pharmacy Benefit Management and the application of federal and state laws. Proven ability to analyze complex issues, develop compliance metrics, and collaborate with cross-functional teams to ensure timely and accurate implementation.

Highest-signal resume keywords

Healthcare ComplianceRegulatory ImplementationsPharmacy Benefit ManagementCompliance SystemsLaws and Regulations Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Regulatory GuidanceBusiness Requirements AnalysisImplementation Metrics MonitoringCompliance Performance MeasuresCaseload Development and Tracking

Soft Skills

LeadershipCollaborationCommunication

Tools & Technologies

Compliance Reporting Tools

Industry Keywords

Department of InsuranceCMSPHIHIPAA

About the role

Key responsibilities & impact

Implement new federal and state rules, including PBM rules, across the enterprise
Serve as subject matter expert and point of contact for state and federal implementations
Lead implementation activity from onset to conclusion
Research, understand, and apply laws, regulations, and regulatory guidance
Analyze business requirements and complex issues
Provide regulatory guidance to business partners, Law, Risk, and Compliance associates and leaders
Develop and track a caseload of enterprise-wide and state-rule implementations
Partner with Law, Risk, Compliance, and operational partners to ensure accurate and timely implementation
Lead and participate in meetings
Monitor implementation metrics and oversight tools
Recommend new compliance performance measures
Provide backup and support to Enterprise Compliance team members
Report to an Associate Director

Requirements

What you’ll need

5 or more years’ experience in healthcare compliance, regulatory implementations, and/or Pharmacy Benefit Management
Knowledge/understanding of laws and regulations governed by the Department of Insurance and CMS
Bachelor’s degree or higher preferred
Experience with compliance systems, metrics, and reporting preferred
Ability to work fully remotely within the US
Internet service with at least 25 Mbps download and 10 Mbps upload speed
Work from a dedicated space lacking ongoing interruptions to protect member PHI/HIPAA information

Benefits

Comp & perks

Bonus incentive plan based on company and/or individual performance
Medical benefits
Dental benefits
Vision benefits
401(k) retirement savings plan
Paid time off
Company holidays
Personal holidays
Paid parental leave
Paid caregiver leave
Short-term disability
Long-term disability
Life insurance
Personal wellness support
Smart healthcare decision support
Occasional travel to Humana offices for training or meetings may be required