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The Compliance Health Insurance Liaison/ Health Insurance Exchange Liaison is primarily focused on Humana’s obligations, as a Qualified Dental Plan (QDP) issuer, to meet all federal Affordable Care Act (ACA) and state-based requirements to participate in their respective programs on the Federally-facilitated Exchange (FFE) and State Based Exchanges (SBEs). This position is responsible for gathering, reviewing, analyzing, and disseminating relevant participation requirements to internal and external partner teams charged with fulfilling those requirements and overseeing program requirements and deliverables to ensure Humana is compliant with these requirements year-over-year in accordance with federal and state-level timelines. This position will also interface with Humana Dental business leaders, including – but not limited to – actuarial, product strategy, product strategy advancement, and network, about the evolving footprint in accordance with Humana Dental’s overall public exchange strategy.Compliance Health Insurance Liaison/ Health Insurance Exchange Liaison will be responsible for:
Exchange Liaison
Establish and maintain effective communication and relationships with numerous Federal and State organizations in support of efforts to participate as a QDP with respect to Exchange operations and integration for Federal and State Based health insurance exchange platforms.
Research, review, analyze, and disseminate regulatory information and requirements to all associated internal teams to support Exchange operations and integration with the Federal and State Based health insurance exchange platforms.
Serve as the single point of contact for multiple Federal and State Based organizations including, but not limited, to state Departments of Insurance (DOIs) in coordination with corporate affairs and regulatory compliance (when appropriate), exchange regulatory boards, and exchange operation committees.
Exchange Facilitator
Research, review, analyze, and disseminate timelines/deadlines/due dates, exchange requirements, and required documents (i.e., templates) to all associated internal teams in support of efforts to participate in Exchange operations and integration with the Federal and State Based health insurance exchange platforms. This dissemination effort includes – but is not limited to – maintenance of Humana’s internal Exchange SharePoint site.
Collaborate with product strategy, product strategy advancement, information technology, vendor, and other implementation teams to gather requirements associated with product development, product expansion specific to Exchange operations (i.e., data transmission) and integration efforts for Federal and State Based health insurance exchange platforms.
Establish and facilitate regular meetings with all associated internal teams in support of Exchange operations and integration efforts for Federal and State Based health insurance exchange platforms.
Partner with Federal and State Regulatory agencies, vendors, and multiple internal teams to analyze requirements to identify and document meaningful executable tasks to establish a workable project plan, calendar, schedule of events, and product guidance for Exchange operations and integration efforts for Federal and State Based health insurance exchange platforms.
Operational ownership of all communication to contribute toward strategy execution for Exchange operations and integration efforts for Federal and State Based health insurance exchange platforms, including documenting processes for managing security access, utilizing each SBE’s portal/website, etc.
Facilitate the gathering of required information and the completion of applications, documents, and points of contact for all Exchange operations and integration efforts for Federal and State Based health insurance exchange platforms in accordance with individual Federal and State regulatory organizations.
In coordination with corporate affairs, assist in collecting and disseminating information about future requirements released by Federal and State regulatory organizations concerning Exchange operations and the Federal and State Based health exchange platforms.
Use your skills to make an impact
Required Qualifications
5 or more years of health industry experience.
3 or more years of ACA/Health Insurance Exchange Qualified Health Plan (QHP) or Qualified Dental Plan (QDP) experience with Federal and/or State Based health insurance exchange platforms
Experience working with directly health insurance regulatory entities
Experience researching and analyzing Federal and State requirements
2 or more years of project leadership experience
Proficient Microsoft 365 (Office) applications, including Word, Excel, Teams, and SharePoint as well as in Adobe Acrobat
Hours: 9am to 5 pm EST; will also work PST hours for SBE support (i.e., occasional meetings
Preferred Qualifications
Experience with Specialty, Dental, and/or Vision products.
Experience/familiarity with the Individual QDP health insurance exchange
3 or more years of experience with Federal and State legislation and policy review and communication to diverse teams across a wide range of disciplines
3 or more years of external facing interactions with Federal and State regulatory agencies.
Demonstrated attention to detail and accuracy
Proven analytical and problem-solving ability
Complex program and project management skillset with the ability to synthesize inputs across multiple disciplines and ensure a quality output
Excellent oral and written communication skills. This includes ability to collaborate effectively with associates across all levels of the organization
Oversight experience working with multidisciplinary teams of high performing subject matter experts
Additional Information
Work Style: Remote US (excluding AK & HI)
Location: This role is posted remote – nationwide. Regardless of location, it is expected that this person will work East Coast (EST) hours and, when needed, will also work West Coast (PST) hours for SBE support (i.e., occasional meetings).
Additional Information
As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, 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
Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/vivaengage and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours
40Pay 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.$94,900 - $130,500 per yearThis 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: 01-02-2026
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.
