Humana Inc
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The Policy Governance Professional 2 policy Governance is the combination of Compliance processes established and executed that are reflected in the organization’s structure and how it is managed and led toward achieving goals. The Policy Governance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
The Policy Governance Professional 2 supports the ongoing development, review, and management of Utilization Management (UM) policies and procedures. This role works closely with UM governance and relevant committees, ensuring documentation and reporting align with regulatory standards and organizational objectives. The position also assists with monitoring and reporting quality metrics, and is responsible for preparing clear, accurate written materials to support compliance and continuous improvement initiatives.
Responsibilities
Assist with the development, review, and maintenance of UM policy and procedure documentation, ensuring compliance with regulatory requirements and enterprise standards.
Support UM governance activities and provide committee support by preparing meeting materials, documenting meeting minutes, and tracking action items.
Collect, analyze, and report on UM quality metrics to inform decision‑making and support continuous improvement efforts.
Prepare clear, concise, and accurate written communications, summaries, and reports related to UM governance, quality metrics, and policy activities.
Facilitate communication and training related to UM policy requirements, reporting resources, and compliance protocols.
Assist with the escalation and documentation of suspected policy violations in accordance with established Humana procedures.
Use your skills to make an impact Required Qualifications
Bachelor’s degree
Less than 5 years of technical experience
Experience with UM operations, policy governance, committee support, and/or quality reporting in a healthcare environment.
Strong written communication and documentation skills.
Familiarity with regulatory standards (e.g., HIPAA, HITRUST, NIST) and compliance practices.
Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
Preferred Qualifications
Graduate or advanced degree
Background in policy or compliance
Benefits
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
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.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our
accessibility resources .
#J-18808-Ljbffr
The Policy Governance Professional 2 supports the ongoing development, review, and management of Utilization Management (UM) policies and procedures. This role works closely with UM governance and relevant committees, ensuring documentation and reporting align with regulatory standards and organizational objectives. The position also assists with monitoring and reporting quality metrics, and is responsible for preparing clear, accurate written materials to support compliance and continuous improvement initiatives.
Responsibilities
Assist with the development, review, and maintenance of UM policy and procedure documentation, ensuring compliance with regulatory requirements and enterprise standards.
Support UM governance activities and provide committee support by preparing meeting materials, documenting meeting minutes, and tracking action items.
Collect, analyze, and report on UM quality metrics to inform decision‑making and support continuous improvement efforts.
Prepare clear, concise, and accurate written communications, summaries, and reports related to UM governance, quality metrics, and policy activities.
Facilitate communication and training related to UM policy requirements, reporting resources, and compliance protocols.
Assist with the escalation and documentation of suspected policy violations in accordance with established Humana procedures.
Use your skills to make an impact Required Qualifications
Bachelor’s degree
Less than 5 years of technical experience
Experience with UM operations, policy governance, committee support, and/or quality reporting in a healthcare environment.
Strong written communication and documentation skills.
Familiarity with regulatory standards (e.g., HIPAA, HITRUST, NIST) and compliance practices.
Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
Preferred Qualifications
Graduate or advanced degree
Background in policy or compliance
Benefits
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
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.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our
accessibility resources .
#J-18808-Ljbffr