Remote Director of Risk Adjustment Regulatory Audits

Humana Inc; Carson City (NV); À distance; USD 150 000 - 206 000; Plein temps

Avantages offerts par ce poste

Bonus incentive plan

Résumé du poste

Humana Inc. is seeking a Director, Risk Management focused on external risk adjustment regulatory audits. This remote role reports to the Associate VP, Risk Adjustment Compliance and requires leading audits, developing strategy, and cross-functional coordination to improve audit efficiency.

Responsibilities include governance of audit processes, analytics, and stakeholder engagement while maintaining Humana’s standards and culture. Occasional travel may be required.

Qualifications

• 5+ years of project and people leadership experience.
• 8-10+ years of experience in strategic operations, analytics, including process improvement and stakeholder influence.
• 5+ years of experience in program development and management, leveraging metrics and performance reporting to track results.
• 5+ years of process improvement and operations experience.

Responsabilités

• Execute regulatory audits strategy and ensure strong operational processes.
• Develop and maintain reporting and tracking of risk adjustment audits.
• Lead crossfunctional collaboration with Quality, Cost & Strategy, and regulatory partners.
• Drive analytics of audit data to inform future risk reduction strategies.
• Identify opportunities to implement tech solutions to improve audit workflow efficiency.
• Manage communications with regulatory bodies throughout audits.
• Set team goals, priorities, staffing, and budgets.
• Demonstrate strong influencing and collaboration skills.

Connaissances

Leadership

Strategic operations

Program development

Process improvement

Description du poste

Humana Inc. is seeking a Director, Risk Management focused on external risk adjustment regulatory audits. This remote role reports to the Associate VP, Risk Adjustment Compliance and requires leading audits, developing strategy, and cross-functional coordination to improve audit efficiency.

Responsibilities include governance of audit processes, analytics, and stakeholder engagement while maintaining Humana’s standards and culture. Occasional travel may be required.