Remote Clinical Risk Leader – Primary Care Operations

Humana Inc; Santa Fe (NM); Remote; USD 104,000 - 143,000; Full time

Job summary

Humana Inc. is seeking a Clinical Risk Management Lead to drive risk assessments and mitigation across the Primary Care Organization, working with clinical and business leaders to improve patient safety and regulatory compliance.

The role supports risk management strategy, reports to the Associate VP, Risk Management, and offers remote work with occasional travel to Humana offices. 40 hours weekly and a strong emphasis on governance and continuous improvement.

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

Clinical risk management

Healthcare risk assessment

Stakeholder collaboration

Regulatory compliance

Analytical thinking

Presentation to leadership

Education

BSN or higher (Nursing/PA/clinical)

Job description

Humana Inc. is seeking a Clinical Risk Management Lead to drive risk assessments and mitigation across the Primary Care Organization, working with clinical and business leaders to improve patient safety and regulatory compliance.

The role supports risk management strategy, reports to the Associate VP, Risk Management, and offers remote work with occasional travel to Humana offices. 40 hours weekly and a strong emphasis on governance and continuous improvement.