New job Medicaid Compliance Specialist in Florida

Medicaid Compliance Specialist

Company : Humana
Salary : Details not provided
Location : Florida

Full Description

The Compliance Professional 2 ensures compliance with governmental requirements. The Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.


The Compliance Professional 2 develops and implements compliance policies and procedures. Researches compliance issues and recommends changes that assure compliance with contract obligations. Maintains relationships with government agencies. Coordinates implementation and compliance with corrective action plans, as needed for process improvement. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Required Qualifications

  • 5 years or more of healthcare experience (Compliance background; Member Material or Reporting, Operational Audits)
  • Ability to manage multiple or competing priorities and meet deadlines
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences
  • Strong attention to detail
  • Excellent Organizational skills
  • Highly motivated individual
  • Intermediate MS Office skills (Excel, Word, PowerPoint)
  • Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) is required.
  • A dedicated home office space, with a locked door, lacking ongoing interruptions to protect member PHI / HIPAA information
  • Work shift will be in Eastern Time Zone

Preferred Qualifications

  • Compliance regulations experience
  • Analytical experience
  • Experience running queries and ad hoc reports in Access and/or SQL
  • Medicaid experience

Scheduled Weekly Hours


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Source : Indded