Architect of Organic Risk Adjustment

Humana, Inc.; Denver (CO); On-site; USD 140,000 - 190,000; Full time

Job summary

Humana, Inc. seeks a Lead, Organic Risk Adjustment to build and scale Humana's Organic Risk Adjustment (ORA) program.

This role is a builder and change agent, not focused on maintaining the status quo, and requires turning ideas into measurable results. You will partner with clinical, operational, analytical, and business leaders to design workflows, engage providers, and drive performance improvements across risk adjustment.

Qualifications

• Demonstrated success 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.

Skills

Leading cross-functional initiatives

Healthcare performance programs

Partnering with senior leaders

Stakeholder influence

Problem solving in ambiguity

Job description

Humana, Inc. seeks a Lead, Organic Risk Adjustment to build and scale Humana's Organic Risk Adjustment (ORA) program.

This role is a builder and change agent, not focused on maintaining the status quo, and requires turning ideas into measurable results. You will partner with clinical, operational, analytical, and business leaders to design workflows, engage providers, and drive performance improvements across risk adjustment.