Manager, Compliance Nurse

Description Humana Healthy Horizons in Florida is seeking a Manager, Compliance Nursing that reviews care management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Manager, Compliance Nursing works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules, and goals. Take advantage of Humana’s competitive pay, lucrative 401k matching programs and more! Apply now to begin your future with a Fortune 40 Company! Responsibilities The Manager, Compliance Nursing ensures: Mandatory reporting is completed timely 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 Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area Requires cross departmental collaboration and conducts briefings and area meetings; maintains frequent contact with other managers across departments. Required Qualifications Bachelor's Degree Nursing, Public Health, Health Administration, Health Policy or Business 4 or more years of technical experience 1 or more years of leadership experience Active licensed Registered Nurse (RN) in the state of Florida, with no disciplinary action. Must be passionate about contributing to an organization focused on continuously improving consumer experiences Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field. Preferred Qualifications Experience with successful collaboration among cross functional leaders and teams Familiar with Humana tools, systems, processes Interview Format As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Work at Home Guidance 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 Scheduled Weekly Hours 40