Remote AVP, Medical Risk Adjustment & Provider Engagement

Humana Inc; Pierre (SD); On-site; USD 246,000 - 344,000; Full time

Benefits offered by this job

Bonus incentive plan

Flexible remote work

Job summary

Humana Inc. is seeking an Associate Vice President of Medical Risk Adjustment and Provider Engagement to lead clinical risk strategies and engage providers nationwide.

You will guide STARS initiatives, oversee risk adjustment education, and develop KPIs, reporting, and education for regional leadership. This senior role requires an MD/DO and a track record in clinical leadership, provider relationships, and performance improvement.

Qualifications

• Advanced clinical degree required (MD/DO).
• Experience leading clinical teams in managed care, risk adjustment, or quality improvement.

Responsibilities

• Provide clinical leadership for STARS and Risk Adjustment initiatives and KPI oversight.
• Drive provider engagement and satisfaction in risk adjustment and clinical quality programs.
• Oversee Stars self-reporting metrics, including clinical oversight and escalation of issues.
• Participate in CMS audits related to Stars and risk adjustment activities.

Skills

Clinical leadership

Provider engagement

Strategic direction

KPIs & reporting

Cross-functional collaboration

Education

MD/DO

Job description

Humana Inc. is seeking an Associate Vice President of Medical Risk Adjustment and Provider Engagement to lead clinical risk strategies and engage providers nationwide.

You will guide STARS initiatives, oversee risk adjustment education, and develop KPIs, reporting, and education for regional leadership. This senior role requires an MD/DO and a track record in clinical leadership, provider relationships, and performance improvement.