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Operational Compliance Consultant II
Location
United States
Posted
50 days ago
Salary
$56K - $92K / year
Seniority
Mid Level
Job Description
Operational Compliance Consultant II
Allstate
• Serve as a primary compliance point of contact for field agencies, brokers, and sales leadership. • Interpret and apply state and federal insurance regulations. • Advise field agencies and internal partners on compliant operational practices. • Identify trends, recurring issues, and agency‑specific risk based on complaints, audits, and escalations. • Lead investigation, documentation, and resolution of compliance‑related issues.
Job Requirements
- 2+ years of experience in insurance compliance, regulatory affairs, operational risk, or agency oversight (preferred).
- Experience working with or supporting field agencies, brokers, or distributed sales organizations strongly preferred.
- Familiarity with life and/or health insurance distribution models.
Benefits
- Health insurance
- 401(k) matching
- Flexible working hours
- Paid time off
- Professional development opportunities
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• Deliver specific course content in an online environment. • Provide instruction, support, and guidance to students. • Manage the learning process focusing on students’ individual needs. • Collaborate with parents to advance each student’s learning. • Ensure compliance documents are completed for special needs students. • Develop IEPs and related state documentation. • Facilitate special education meetings and provide the necessary resources to students. • Ensure students participate successfully in general education classrooms. • Document all contacts and analyze student data for remediation needs.
Director, Government Compliance
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Compliance Manager
Rising Medical SolutionsWe treat out clients' money, time, health, and information as if it were our own.
• Oversee the coordination of resources to ensure the ongoing effectiveness of the state managed care programs • Tracks applicable laws and regulations in the jurisdictions in which Rising participates in the state managed care plans • Tracks applicable medical bill review laws and regulations nationwide • Develop and maintain managed care resource materials for Rising state filings and customer worksite materials • Managed care report filings as required quarterly, semi-annually • Maintain historical archive of customer managed care filings • Proactive and diplomatic with client concerns • Active participation in cross-functional team efforts for implementation and ongoing support of client program • In this role, the Compliance Manager also manages the California MPN Coordinator team of Medical Access Assistants, including fostering development and understanding of MPN rules and application of those rules by way of assistance for all MPN requests from injured workers, customers, adjusters, and attorneys. The manager monitors all MPN requests received which includes the audit log and escalates appropriate solutions to delays in treatment or scheduling, tracks progression of scheduling tasks assigned to the MPN coordinator, assists with evaluation of geo analysis reports identifying areas and specialties of the MPN network in need of additional coverage and serves as backup key responder at times when the MPN coordinator is out of the office. • The Compliance Manager maintains the timely pay portal, regularly reviewing state regulations and rules (all states) for Medical Bill Review timely billing, payment, late paid penalties, timely reconsideration and dispute requests, explanation of review (EOR) requirements, electronic billing, and other categories as needed to ensure compliancy with these rules and updates of our timely pay dashboards. In this role, regular research of all state published updates are monitored for changes in government regulations, industry trends, and developments pertaining to Rising lines of business, and communicated to Rising staff and customers of the key changes in federal and state rules and regulations. • Management of Rising’s fraudulent provider workflow and team, including monitoring state regulatory websites for posted updates of providers who have been officially suspended or removed from participating in the workers’ compensation, or alerts of providers involved in fraudulent activity, arrests, or convictions (all states). Oversee assignments to validate reported fraudulent provider’s tax ID and NPI numbers, entry flags into our Vision system, alerting our bill auditors and utilization review nurses, should the provider be associated with a bill received or open claim.
Become a part of our caring community Are you passionate about navigating complex regulations and turning compliance into a strategic advantage? Join our team as a Senior Compliance Professional, where you’ll play a critical role in ensuring adherence to governmental and regulatory requirements while helping protect and strengthen the organization. In this dynamic role, you’ll tackle moderately complex to highly complex compliance initiatives, analyzing policies, data, and evolving regulations to identify risks and drive solutions. Your work will require deep critical thinking, sound judgment, and an in-depth evaluation of variable factors to resolve sophisticated issues and support informed decision-making across the organization. This is an opportunity to make a meaningful impact—partnering with key stakeholders, influencing compliance outcomes, and contributing to an environment where integrity and accountability are at the forefront. 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WAH Internet Statement 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. 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. 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 04-15-2026 About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com. 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.



