Associate Director Compliance - Medicare Risk Adjustment

Welcome to Humana! We are a leading healthcare company that is dedicated to helping our members achieve their best health. As an Associate Director Compliance for our Medicare Risk Adjustment team, you will play a critical role in ensuring our compliance with all Medicare regulations related to risk adjustment. We are seeking a highly motivated and experienced individual who is passionate about compliance and has a strong understanding of Medicare regulations. If you are looking for an opportunity to make a meaningful impact and contribute to the success of our Medicare business, then we would love to hear from you. Join our team and be a part of our mission to improve the health and well-being of our members.

1. Develop and implement compliance policies and procedures related to Medicare risk adjustment, ensuring alignment with all applicable regulations and guidelines.
2. Oversee and monitor the compliance program for the Medicare risk adjustment team, conducting regular audits and assessments to identify and address any areas of non-compliance.
3. Collaborate with cross-functional teams to ensure compliance with Medicare regulations throughout all stages of the risk adjustment process, including data submission, coding, and reporting.
4. Stay up-to-date on all changes and updates to Medicare regulations and guidelines, and communicate any potential impacts or changes to the risk adjustment program to relevant stakeholders.
5. Conduct training and education sessions for team members and other relevant stakeholders to promote understanding and adherence to Medicare compliance regulations.
6. Serve as the primary point of contact for Medicare compliance inquiries and investigations, working closely with regulatory agencies and internal teams to facilitate timely and accurate responses.
7. Analyze and report on compliance metrics and trends, identifying areas for improvement and implementing corrective action plans as needed.
8. Foster a culture of compliance within the organization by promoting ethical behavior and adherence to regulations and guidelines at all levels.
9. Represent the organization in compliance-related meetings and presentations, providing subject matter expertise and representing our commitment to compliance.
10. Continuously evaluate and improve compliance processes and procedures to ensure the highest level of compliance and efficiency within the Medicare risk adjustment program.

According to JobzMall, the average salary range for a Associate Director Compliance - Medicare Risk Adjustment in Louisville, KY, USA is $91,000-$130,000 per year. However, this can vary depending on factors such as education, experience, and specific job responsibilities.

Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. Its strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people they serve across the country. The company operates its business through the following segments: Retail, Group, and Healthcare Services.