Lead Compliance Specialist

Humana·Richmond, Virginia, US

legalnow

Projected AI Stack

Based on our analysis of Compliance Officers positions

⚡ 6.8 — Very High AI Upgrade Potential

CLClaudeDraft compliance policy documents, Code of Conduct updates, and investigation summariesweekly

PXPerplexityMonitor anti-bribery, ABAC, and sanctions regulatory developments across jurisdictionsdaily

MCMicrosoft 365 CopilotSummarize speak-up case files and format third-party risk assessment reportsdaily

Projected Workflow

How AI is expected to reshape this role

AI-assisted

Regulatory update monitoring and researchPerplexity

Policy drafting and Code of Conduct revisionsClaude

Case file summarization and reportingMicrosoft 365 Copilot

Human-led

Internal investigations and speak-up matter resolution

Third-party due diligence and vendor risk decisions

Gifts, hospitality, and conflicts of interest adjudication

Cross-functional stakeholder engagement on compliance issues

This AI stack and workflow map are projected by UpgradedJobs based on occupational analysis, not stated by the employer. They reflect how AI tools are transforming Compliance Officers roles today.

About the role

Join Our Supportive Community

The Lead Compliance Specialist, reporting to the Associate Director of Compliance, plays a vital role in upholding our commitment to complex regulatory and contractual requirements. This opportunity is ideal for an accomplished compliance expert who thrives in a structured corporate setting and is driven by the desire to make a meaningful impact, exercise independence, and influence strategy.

You will tackle compliance challenges that range from moderately complex to complex, requiring exceptional problem-solving skills, regulatory knowledge, and the capability to transform requirements into sustainable compliance practices.

Main Responsibilities

The Lead Compliance Specialist will develop, implement, and maintain compliance policies, procedures, and programs that reinforce regulatory integrity and operational efficiency.

You will:

Interpret and apply federal, state, and contractual obligations, including those governed by CMS and the Department of Insurance.
Research evolving regulations and propose compliance enhancements to ensure alignment and risk mitigation.
Serve as the primary liaison, fostering positive relationships with regulatory bodies and government agencies.
Oversee the first line sale compliance team.
Review, assess, and offer compliance recommendations for marketing materials in accordance with CMS regulations.
Guide the development and monitoring of corrective action plans.
Establish compliance metrics and reporting mechanisms to evaluate program effectiveness and provide insights to leadership.
Contribute to departmental initiatives while starting to shape compliance strategy.

You will operate with a high degree of autonomy and apply sound judgment in setting goals, priorities, and technical methodologies.

Utilize Your Skills for a Meaningful Impact

Required Qualifications

Bachelor's degree.
Five (5) or more years of experience in compliance, audit, consulting, or a related regulatory field.
Strong understanding of CMS and Department of Insurance regulations.
Experience in compliance auditing, monitoring, and developing corrective action plans.
Experience in compliance analysis and metric reporting.
Proven track record of independently managing complex issues and influencing outcomes.
Experience in oversight of Medicare sales.
Proficiency in reviewing marketing materials to ensure compliance with regulatory standards.

Preferred Qualifications

Graduate or advanced degree.
Experience in contributing to compliance program development or departmental strategy.

Travel: While this position is remote, occasional travel to Humana's offices for training or meetings may be necessary.

Scheduled Weekly Hours

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full-time employment at the time of posting. Pay may vary based on geographic location and individual experience, skills, education, certifications, and performance.

$86,300 - $118,700 per year.

This position is eligible for a bonus incentive plan based on individual and company performance.

Description of Benefits

Humana, Inc. offers a competitive benefits package that supports holistic well-being. Our associate benefits aim to promote personal wellness and informed healthcare decisions for you and your family while acknowledging that your life extends beyond work. Included are medical, dental, and vision benefits, a 401(k) retirement savings plan, time off (including paid vacation, company holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance, and many additional opportunities.

Application Deadline: 07-29-2026

About Us

Humana Inc. is a leading U.S. healthcare company. Through our Humana insurance services and CenterWell healthcare services, we help millions achieve their best health by providing the care and service they need, when they need it. We are dedicated to enhancing the quality of life for individuals with Medicare and Medicaid, families, individuals, military personnel, and various communities. Learn more about us at Humana.com and CenterWell.com.

Equal Opportunity Employer

Humana's policy prohibits discrimination against employees or applicants based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or protected veteran status. We also promote affirmative action to ensure compliance with employment laws for individuals with disabilities or protected veteran status, basing all employment decisions solely on valid job requirements. This policy is applied to all employment actions, including recruitment, hiring, promotion, transfers, and other employment-related decisions.

Humana is committed to complying with all federal civil rights laws and ensures no discrimination based on race, color, national origin, age, disability, sex, sexual orientation, gender identity, or religion. We provide free language interpreter services.