Remote Clinical Risk Management Lead

Humana Inc; Augusta (ME); Remote; USD 104,000 - 143,000; Full time

Benefits offered by this job

Health benefits

Dental and vision

401(k) plan

Paid time off

Job summary

Humana Inc. is seeking a Clinical Risk Management Lead to identify, assess, monitor, and mitigate risks across clinical practice and operations within the CenterWell Senior Primary Care ecosystem.

You will partner with clinical and business leaders to implement risk controls aligned with organizational objectives. The role reports to the Associate VP of Risk Management and requires collaboration with Compliance, Legal, Privacy, HR, and Enterprise Health & Safety.

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.

Education

Bachelor's degree or higher in Nursing/ Physician Assistant Studies/ related clinical discipline

Active and unrestricted clinical license

5+ years of clinical healthcare experience

Experience collaborating with clinical leadership

Analytical, communication, problem-solving, and risk assessment skills

Ability to evaluate clinical processes and mitigate risks

Experience presenting recommendations to leadership

Job description

Humana Inc. is seeking a Clinical Risk Management Lead to identify, assess, monitor, and mitigate risks across clinical practice and operations within the CenterWell Senior Primary Care ecosystem.

You will partner with clinical and business leaders to implement risk controls aligned with organizational objectives. The role reports to the Associate VP of Risk Management and requires collaboration with Compliance, Legal, Privacy, HR, and Enterprise Health & Safety.