[Remote] Health Insurance Exchange Liaison

Note: The job is a remote job and is open to candidates in USA. Humana Inc. is committed to putting health first and is seeking a Health Insurance Exchange Liaison to ensure compliance with federal and state regulations related to health insurance exchanges. The role involves communication with regulatory bodies, analysis of requirements, and collaboration with various internal teams to support Humana's participation in exchange operations.


Responsibilities

  • 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
  • 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

Skills

  • 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
  • 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

Benefits

  • 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

Company Overview

  • Humana is a health insurance provider for individuals, families, and businesses. It was founded in 1964, and is headquartered in Louisville, Kentucky, USA, with a workforce of 10001+ employees. Its website is http://www.humana.com.

  • Company H1B Sponsorship

  • Humana has a track record of offering H1B sponsorships, with 202 in 2025, 246 in 2024, 284 in 2023, 274 in 2022, 212 in 2021, 84 in 2020. Please note that this does not guarantee sponsorship for this specific role.

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