Remote Clinical Risk & Governance Lead

Humana Inc; Trenton (NJ); Remote; USD 104,000 - 143,000; Full time

Benefits offered by this job

Bonus incentive plan

Remote work option

Travel for training/meetings

Job summary

Humana Inc. is seeking a Clinical Risk Management Lead to oversee risk assessments and mitigation across the Primary Care Organization, guiding clinical and operational teams to strengthen controls and governance.

The role reports to the Associate VP, Risk Management and partners with leaders across CenterWell Senior Primary Care, Conviva, and MaxHealth. The position emphasizes collaboration with Compliance, Legal, Privacy, HR, and Enterprise Health & Safety, with travel as needed and a

Qualifications

• Bachelor's degree or higher in Nursing, Physician Assistant Studies, or a related clinical discipline.
• Active and unrestricted clinical license.
• 5+ years of clinical healthcare experience.
• Experience collaborating with clinical leadership and interdisciplinary stakeholders.
• Strong analytical, communication, problem-solving, and risk assessment skills.
• Ability to evaluate clinical processes, identify risks, and recommend practical solutions.
• Experience presenting recommendations and findings to leadership audiences.

Responsibilities

• Conduct clinical risk assessments to identify, evaluate, and prioritize risks related to clinical operations, patient care, and healthcare delivery.
• Develop and execute clinical risk management plans, including assessment of existing controls and recommendations for risk mitigation strategies.
• Partner with clinical leadership to evaluate risks and support the implementation of effective controls and corrective actions.
• Present findings, recommendations, and risk mitigation strategies to leadership and key stakeholders.
• Collaborate with Compliance, Legal, Privacy, Human Resources, Enterprise Health & Safety, and other internal teams on risk-related initiatives.
• Identify, document, and support resolution of business issues related to clinical practice and operational processes.
• Guide business and clinical partners through risk mitigation and corrective action planning.
• Conduct research, gather information, interview stakeholders, and evaluate clinical risk scenarios to support objective risk assessments.
• Monitor emerging risks, trends, and regulatory requirements affecting primary care and value-based care operations.
• Support continuous improvement efforts related to risk management frameworks, controls, and clinical governance processes.

Skills

Risk management

Risk assessment

Stakeholder collaboration

Analytical skills

Communication

Presentation to leaders

Education

Nursing degree

Physician Assistant studies

Clinical discipline degree

Job description

Humana Inc. is seeking a Clinical Risk Management Lead to oversee risk assessments and mitigation across the Primary Care Organization, guiding clinical and operational teams to strengthen controls and governance.

The role reports to the Associate VP, Risk Management and partners with leaders across CenterWell Senior Primary Care, Conviva, and MaxHealth. The position emphasizes collaboration with Compliance, Legal, Privacy, HR, and Enterprise Health & Safety, with travel as needed and a