Remote Clinical Risk Management Lead

Humana Inc; Honolulu (HI); Remote; USD 104,000 - 143,000; Full time

Job summary

Humana Inc is hiring a Clinical Risk Management Lead to oversee risk assessment and mitigation across the Primary Care Organization. You will partner with clinical and business leaders to evaluate risk exposure, design controls, and support regulatory compliance in a remote work setting.

The role reports to the Associate VP, Risk Management and involves collaboration with CenterWell Senior Primary Care, Conviva, and MaxHealth teams.

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 and patient care.
• Develop and execute clinical risk management plans with control assessments and mitigation strategies.
• Partner with clinical leadership to implement effective controls and corrective actions.
• Present findings and risk mitigation strategies to leadership and stakeholders.
• Collaborate with Compliance, Legal, Privacy, HR, and other teams on risk initiatives.
• Identify and support resolution of business issues related to clinical practice and operations.
• Guide partners through risk mitigation and corrective action planning.
• Monitor emerging risks and regulatory requirements affecting primary care and value-based care.
• Support continuous improvement of risk management frameworks and governance processes.

Skills

Analytical skills

Communication

Problem-solving

Risk assessment

Education

Bachelor's degree or higher in Nursing or PA or related clinical discipline

Job description

Humana Inc is hiring a Clinical Risk Management Lead to oversee risk assessment and mitigation across the Primary Care Organization. You will partner with clinical and business leaders to evaluate risk exposure, design controls, and support regulatory compliance in a remote work setting.

The role reports to the Associate VP, Risk Management and involves collaboration with CenterWell Senior Primary Care, Conviva, and MaxHealth teams.