Lead Organic Risk Adjustment & Transformation

Humana, Inc.; Augusta (ME); On-site; USD 150,000 - 230,000; Full time

Job summary

Humana, Inc. seeks a Lead, Organic Risk Adjustment to build, operationalize, and scale the ORA program across the enterprise.

This role goes beyond maintaining processes, demanding a builder mindset, strategic thinking, and strong execution to translate ideas into measurable results. You will partner with clinical, operational, analytical, and business leaders to identify opportunities, design workflows, and drive adoption within provider workflows, aiming for sustainable performance

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.

Job description

Humana, Inc. seeks a Lead, Organic Risk Adjustment to build, operationalize, and scale the ORA program across the enterprise.

This role goes beyond maintaining processes, demanding a builder mindset, strategic thinking, and strong execution to translate ideas into measurable results. You will partner with clinical, operational, analytical, and business leaders to identify opportunities, design workflows, and drive adoption within provider workflows, aiming for sustainable performance