Innovative Financial Group (IFG), a wholly owned Field Marketing Organization (FMO) and subsidiary of Humana and we are looking for a dedicated and experienced Senior Compliance Professional specializing in Medicare Advantage to join our Compliance Team. This role is pivotal in ensuring that our organization and partners comply with all applicable regulations and contracts while also supporting our growth initiatives within this segment. You will monitor and oversea insurance agents and agencies for compliance of policy and procedures and federal and states regulations.
Key Role Functions
Research and investigate allegations of agent/agency misconduct and assign the appropriate corrective action, based on a review of relevant documentation for Internal agents
Analyze, identify and report trends generating agent-related complaints to include CTMs and take actions to reduce Carrier CTMs and complaints
Identify solutions to systemic problems identified
Demonstrate an understanding of Medicare regulations and an ability to apply the regulations
Respond to interdepartmental inquiries
Coordinate and maintain relationships with Carriers, partner agents and agencies
Makes decisions on moderately complex to complex issues regarding technical approach for assignments, and work is performed with minimal direction
Handle urgent sensitive work in an expeditious manner
Monitor changes in Carrier policies, Medicare regulations, providing insights and recommendations to leadership and internal teams
Collaborate with cross-functional teams, including marketing, operations, and sales, to ensure compliance is integrated into all aspects of Medicare Advantage initiatives
Prepare and maintain documentation for compliance activities, including reports, training materials, and audit findings
Participate in the development of policies and procedures to enhance compliance operations and risk management
Use your skills to make an impact
Required Qualifications
- 3+ years of experience in compliance within the insurance industry, with a focus on Medicare Advantage
- 1+ years of audit or consulting experience
- Experience with metric monitoring and reporting
- Strong understanding of Medicare regulations, CMS guidelines, and compliance best practices
- Excellent analytical skills with the ability to assess complex regulatory requirements and develop actionable strategies
- Strong communication and interpersonal skills to effectively collaborate with various stakeholders
- Proven ability to work independently and manage multiple priorities in a fast-paced environment
Preferred Qualifications
- Bachelor’s degree or higher in Business, Finance, Law, Healthcare Administration, or a related field
- Compliance certification e.g. CHC
Additional Information
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
- Satellite, cellular and microwave connection can be used only if approved by leadership
- Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
- Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Our Hiring Process
As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called HireVue. HireVue Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.
If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.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.
$86,300 - $118,700 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 07-31-2026
