Remote Clinical Risk Lead for Primary Care

Humana Inc; Atlanta (GA); Remote; USD 104,000 - 143,000; Full time

Job summary

Humana Inc. is seeking a Clinical Risk Management Lead to coordinate risk assessment and mitigation across the Primary Care Organization, identifying, evaluating, and monitoring risks in clinical practice and patient care.

You will collaborate with clinical and business leaders, report to the Associate VP, Risk Management, and guide cross-functional teams on control design, issue mitigation, and compliance with regulatory requirements.

Qualifications

• Bachelor's degree or higher in Nursing, PA, or related clinical field.
• 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 solutions.
• Experience presenting recommendations to leadership.

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

5+ years experience

Analytical

Communication

Problem solving

Risk assessment

Leadership collaboration

Education

Bachelor's degree or higher in Nursing/PA or related clinical field

Job description

Humana Inc. is seeking a Clinical Risk Management Lead to coordinate risk assessment and mitigation across the Primary Care Organization, identifying, evaluating, and monitoring risks in clinical practice and patient care.

You will collaborate with clinical and business leaders, report to the Associate VP, Risk Management, and guide cross-functional teams on control design, issue mitigation, and compliance with regulatory requirements.