Lead, Organic Risk Adjustment & Transformation

Humana, Inc.; Dover; On-site; GBP 120,000 - 180,000; Full time

Job summary

Humana, Inc. is seeking a Lead, Organic Risk Adjustment to build, operationalize, and scale its ORA program in the UK.

This is a builder and change-agent role that thrives on creating structure, solving complex challenges, and turning ideas into measurable results. You will collaborate with clinical, operational, analytical, and business leaders to improve program performance and embed risk adjustment into routine provider workflows.

Qualifications

• Experience leading large-scale cross-functional initiatives from concept through implementation.
• Experience in Medicare Advantage, value-based care, population health, healthcare operations, quality improvement, risk adjustment, or related healthcare performance programs.
• Experience partnering with senior leaders to drive organizational change and operational improvement.
• Proven ability to influence stakeholders across clinical, operational, analytical, and business teams.
• Strong problem-solving skills with the ability to navigate ambiguity and create structure in evolving environments.

Responsibilities

• Build and operationalize programs that improve Organic Risk Adjustment performance.
• Design and implement workflows, playbooks, provider engagement approaches, and reporting processes from the ground up.
• Identify opportunities, develop action plans, and drive execution through completion.
• Manage multiple initiatives simultaneously while ensuring measurable business outcomes.
• Serve as the point person for day-to-day execution of key Organic Risk Adjustment initiatives.
• Create structure, processes, and operating models in areas where established solutions do not yet exist.
• Translate strategic priorities into executable work plans and deliverables.
• Lead complex, cross-functional initiatives involving clinical, operational, analytical, and business partners.
• Partner with senior leaders to identify opportunities, align priorities, and remove barriers to execution.
• Challenge existing processes and traditional approaches to create more effective, scalable, and sustainable solutions.
• Influence decisions and drive action across stakeholders without direct authority.
• Help shape the future direction and operating model of Organic Risk Adjustment as the program evolves.
• Foster a culture of innovation, continuous improvement, and accountability.
• Partner with providers, practice leaders, operations teams, and clinical stakeholders to improve performance and outcomes.
• Develop practical solutions that fit within existing provider and operational workflows.
• Facilitate meetings, maintain alignment, and ensure follow through on commitments and action plans.
• Build strong working relationships across a diverse set of stakeholders and business partners.
• Analyze data to identify performance improvement opportunities and operational insights.
• Translate findings into actionable recommendations and implementation plans.
• Monitor program outcomes and adjust strategies based on results.
• Develop reporting approaches that support decision-making, accountability, and continuous improvement.

Skills

Leadership

Medicare Advantage

Population health

Risk adjustment

Quality improvement

Stakeholder influence

Job description

Humana, Inc. is seeking a Lead, Organic Risk Adjustment to build, operationalize, and scale its ORA program in the UK.

This is a builder and change-agent role that thrives on creating structure, solving complex challenges, and turning ideas into measurable results. You will collaborate with clinical, operational, analytical, and business leaders to improve program performance and embed risk adjustment into routine provider workflows.