Remote Director of Risk Adjustment Audits

Humana Inc; Cheyenne (WY); Remote; USD 150,000 - 206,000; Full time

Job summary

Humana Inc. is seeking a Director, Risk Adjustment Regulatory Audits to lead the strategy and execution of external risk adjustment audits.

The role emphasizes strong operational processes, regulatory communication, and data-driven improvements across Humana’s audit workflow. The position offers remote work and requires collaboration with the risk adjustment compliance team and senior leadership to drive efficiency and outcomes.

Qualifications

• 5+ years of project and people leadership experience.
• 8-10+ years in strategic operations and analytics with process improvement and stakeholder influence.
• 5+ years in program development and management with metrics-based performance reporting.
• 5+ years of process improvement and operations experience.

Responsibilities

• Lead and manage external regulatory risk adjustment audits for Humana.
• Develop strategy and execution plans for audit programs.
• Ensure strong operational processes for intake and submission of audits.
• Communicate with regulatory bodies and track audit performance.
• Identify opportunities to implement technology to improve audit workflows.
• Foster crossfunctional partnerships across Humana and with legal and regulatory teams.
• Set goals, priorities, staffing and budget for the team, and drive a positive Humana culture.

Skills

Project leadership

People leadership

Strategic operations

Analytics

Process improvement

Stakeholder influence

Program management

Metrics reporting

Job description

Humana Inc. is seeking a Director, Risk Adjustment Regulatory Audits to lead the strategy and execution of external risk adjustment audits.

The role emphasizes strong operational processes, regulatory communication, and data-driven improvements across Humana’s audit workflow. The position offers remote work and requires collaboration with the risk adjustment compliance team and senior leadership to drive efficiency and outcomes.