Lead, Organic Risk Adjustment & Transformation

Humana; Lansing (MI); On-site; USD 150,000 - 210,000; Full time

Job summary

Humana is seeking a Lead, Organic Risk Adjustment to build, operationalize, and scale the ORA program across the enterprise. This role is a hands-on builder and change agent, shaping strategy and driving large-scale initiatives with senior leaders and diverse stakeholders.

The ideal candidate thrives in ambiguity, designs new workflows and operating models, and translates strategic priorities into executable work plans.

Qualifications

• Experience leading large-scale, cross-functional initiatives from concept to implementation.
• Experience in Medicare Advantage, value-based care, population health, healthcare operations, 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

Cross-functional collaboration

Stakeholder management

Analytical thinking

Problem solving

Communication

Job description

Humana is seeking a Lead, Organic Risk Adjustment to build, operationalize, and scale the ORA program across the enterprise. This role is a hands-on builder and change agent, shaping strategy and driving large-scale initiatives with senior leaders and diverse stakeholders.

The ideal candidate thrives in ambiguity, designs new workflows and operating models, and translates strategic priorities into executable work plans.