Lead Organic Risk Adjustment Architect (Remote)

Humana; United States; Remote; USD 115,000 - 158,000; Full time

Job summary

Humana is seeking a Lead, Organic Risk Adjustment to build, operationalize, and scale Humana’s Organic Risk Adjustment (ORA) program. This is not a role focused on maintaining existing processes or operating from the sidelines.

We are looking for a builder and change agent who enjoys creating structure where it does not exist, solving complex business challenges, and turning ideas into measurable results. The role will partner closely with clinical, operational, analytical, and business leaders

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.
• Ability to analyze data trends, identify opportunities, and translate insights into operational action plans.
• Strong communication, facilitation, and stakeholder management skills.

Responsibilities

• 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.

Skills

Leadership

Cross-functional work

Healthcare domain

Stakeholder influence

Problem-solving

Data analysis

Communication

Job description

Humana is seeking a Lead, Organic Risk Adjustment to build, operationalize, and scale Humana’s Organic Risk Adjustment (ORA) program. This is not a role focused on maintaining existing processes or operating from the sidelines.

We are looking for a builder and change agent who enjoys creating structure where it does not exist, solving complex business challenges, and turning ideas into measurable results. The role will partner closely with clinical, operational, analytical, and business leaders