Remote Clinical Risk Management Lead

Humana Inc; Boise (ID); Remote; USD 104,000 - 143,000; Full time

Job summary

Humana Inc seeks a Clinical Risk Management Lead to support risk management across the Primary Care Organization by identifying, assessing, monitoring, and mitigating risks in clinical practice, patient care and regulatory compliance. You will partner with clinical and business leaders to evaluate risk exposure and implement controls.

The role reports to the Associate VP, Risk Management and works with cross-functional teams including Compliance, Legal, Privacy and Human Resources to drive

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

License in nursing/PA

5+ years clinical healthcare

Analytical skills

Communication skills

Risk assessment

Leadership presentation to leadership

Education

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

Job description

Humana Inc seeks a Clinical Risk Management Lead to support risk management across the Primary Care Organization by identifying, assessing, monitoring, and mitigating risks in clinical practice, patient care and regulatory compliance. You will partner with clinical and business leaders to evaluate risk exposure and implement controls.

The role reports to the Associate VP, Risk Management and works with cross-functional teams including Compliance, Legal, Privacy and Human Resources to drive