Become a part of our caring community and help us put health first The Compliance Registered Nurse 2 role directly supports the organization's ability to maintain contractual compliance, achieve and sustain NCQA accreditation, and mitigate risk through diligent oversight, policy enforcement, and ongoing education. The role of a Compliance Nurse will be to manage state contracts, policies, NCQA accreditation requirements, and monthly auditing. This is critical in ensuring organizational adherence to regulatory standards and internal protocols. This position is responsible for the implementation, oversight, and continuous monitoring of compliance with both state and federal regulations, as well as industry accreditation requirements such as those established by the National Committee for Quality Assurance (NCQA). In this role you will ensure mandatory reporting is completed. Conducts and summarizes compliance audits. Collects and analyzes data daily, weekly, monthly or as needed to assess outcome and operational metrics for the team and individuals. 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. Use your skills to make an impact Required Qualifications - Active RN license in the state of South Carolina - 1-2 years’ experience with National Committee for Quality Assurance (NCQA) and state audits - Proficient with Microsoft Office products including Word, Excel and Outlook - Ability to work independently under general instructions and with a team - Must be passionate about contributing to an organization focused on continuously improving consumer experience Preferred Qualifications - BSN - Health Plan experience working with large carriers - Previous Medicare/Medicaid experience a plus - Previous experience in utilization management, case management, discharge planning and/or home health or rehab - Certification in Case Management a plus (CCM) - Knowledge with MCG or Interqual guidelines Additional Information Note: There will be occasional travel to the office for team meet ups at least two times per year. Work-At-Home Requirements To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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. - Associates 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 associates 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. Interview Format As part of our hiring process for this opportunity, we will be using exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first-round interview, you will receive an email correspondence inviting you to participate in a HireVue interview. In this interview, you will receive a set of interview questions over your phone, and you will provide recorded or text message responses to each question. For best interview experience use a computer over a phone. You should anticipate this interview to take about 15-20 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Humana Benefits Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including: Health benefits effective day 1 Paid time off, holidays, volunteer time and jury duty pay Recognition pay 401(k) retirement savings plan with employer match Tuition assistance Scholarships for eligible dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development opportunities 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. $71,100 - $97,800 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. 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. ​ 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.

• Maintain and update the master audit schedule to ensure all vendors are audited within the required five-year cycle. • Track and report monthly audit completion rates, audit types (physical, paper, transportation), and findings. • Coordinate logistics for audits, including scheduling and auditor assignments. • Develop, update, and standardize audit templates, checklists, and report formats. • Ensure all audit documentation is properly filed, accessible, and compliant with SOPs. • Prepare summary reports for management on audit program status, trends, and risk indicators. • Monitor and follow up on corrective actions resulting from audit findings. • Maintain records of supplier insurance and regulatory compliance documentation. • Assist in developing and updating SOPs related to auditing and vendor management. • Conduct physical, paper, and transportation audits, including on-site visits and document reviews. • Evaluate vendor compliance with RCRA, TSCA, DOT, and other applicable regulations. • Analyze audit results to identify compliance gaps, risks, and improvement opportunities. • Develop and recommend corrective actions based on regulatory requirements and audit findings. • Communicate audit results and compliance expectations to vendors and internal stakeholders. • Provide technical guidance on regulatory requirements and best practices. • Develop and execute outreach plans to communicate upcoming audits to vendors. • Track audit frequency for each vendor to ensure compliance with cycle requirements. • Monitor audit resource allocation and recommend adjustments to meet annual targets. • Prepare monthly progress reports on audit volume and cycle compliance.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Quality Compliance & Reporting Coordinator will be responsible for ensuring that the Value Hub adheres to regulatory standards, contract requirements, and internal quality benchmarks. This role involves: - Analyzing compliance data - Preparing detailed reports - Working closely with various departments to maintain and improve compliance and quality standards - Supporting the understanding of local regulatory requirements - Completion of local audits - Participation in quality committees - Supporting health plan needs and interactions to ensure consistent implementation of contractual obligations between CommonSpirit Health, our payers, and our network providers Along with CO, KS, and NM, this position is open to remote/out of state candidates residing in only these states: - Alabama - Arizona - Arkansas - Colorado - Florida - Georgia - Idaho - Indiana - Iowa - Kansas - Kentucky - Louisiana - Missouri - Mississippi - Nebraska - New Mexico - North Carolina - Ohio - Oklahoma - South Carolina - South Dakota - Tennessee - Texas - Utah - Virginia - West Virginia - Wyoming Qualifications - Two or more years experience in an administrative position - Experience in quality assurance, compliance, or pay-for-performance or similar programs preferred - Experience in creating and manipulating data with spreadsheets and/or databases using Excel, Access or other similar programs and/or applications such as G Suite: Slides, Docs, Sheets, etc. - Associates degree or a clinical Certification, such as medical assistant preferred Requirements - Ability to create professional documents using proper grammar, punctuation, and appropriate reading level - Awareness of healthcare industry, including key regulatory bodies - Ability to learn and use other software to conduct duties - Willingness to work as part of a team, working with others to achieve goals, solve problems, and meet established organizational objectives - Must be reliable in attendance and timeliness to work - Must be attentive to detail, accurate, thorough, and persistent in following through to completion all activities, demonstrating initiative for completing work assignments - Ability to communicate effectively in verbal and written form - A self-motivator with the ability to function independently - Extensive knowledge of Microsoft Office applications; Excel, Word, Outlook, PowerPoint as well as G Suite: Slides, Docs, Sheets, etc. - Statistical analysis and database skills a plus - Physical Requirements: Sedentary work (prolonged periods of sitting and exert up to 10lbs force occasionally)

• Partner with product and marketing teams to ensure compliance with consumer protection regulations in the development, launch, and enhancement of deposit, payment, and lending products, providing strategic guidance on regulatory requirements and operational implementation. • Lead the evaluation and interpretation of compliance requirements for new and existing products, ensuring alignment with EarnIn’s compliance framework and regulatory expectations through research, analysis, and documentation. • Monitor and analyze new and evolving regulatory requirements, assessing their impact on products, marketing practices, and internal processes, and driving updates to policies, procedures, and controls to maintain compliance. • Own the development, implementation, and ongoing maintenance of compliance policies, procedures, and controls, conducting periodic reviews and driving enhancements to strengthen the compliance program. • Collaborate with cross-functional teams to design and oversee monitoring and testing activities that assess adherence to compliance policies, identify potential risks, and implement corrective actions where necessary. • Partner with Compliance Managers in compliance risk assessments, ensuring risks are properly documented and necessary controls are in place. • Drive cross-functional initiatives and projects related to product and marketing compliance, ensuring compliance objectives are integrated into project planning and execution. • Provide clear, practical regulatory guidance to stakeholders, translating complex regulatory requirements into actionable recommendations that enable compliant product development and marketing practices. • Manage and develop a team of compliance professionals by setting clear expectations, providing actionable feedback, and supporting growth. • Set and execute near-term strategic plans, monitor workload and performance, and ensure consistent, high-quality delivery. • Foster a collaborative, accountable team culture and serve as a trusted cross-functional partner to promote a strong culture of compliance. • Excellent analytical, organizational, written, and verbal communication skills, with the ability to clearly document complex investigations and regulatory analyses. • High integrity, professionalism, and discretion in handling sensitive information. • Perform other duties as assigned.