Remote Senior Risk & Compliance Leader – Pharmacy

Humana Inc; Carson City (NV); Remote; USD 86,000 - 119,000; Full time

Job summary

Humana Inc. is seeking a Senior Risk Management Professional to identify, assess, and mitigate compliance and operational risks within the Humana Pharmacy Solutions space.

You will partner with risk operations, vendor teams, and business owners to strengthen controls and reporting. You will design monitoring programs, support audit readiness, and develop executive dashboards to highlight risk trends and remediation progress, while navigating CMS and Medicaid requirements in a remote work

Qualifications

• Bachelor’s degree or equivalent, or 5+ years of related experience in PBM operations or risk management.
• Strong analytical and problem-solving abilities.
• Experience coordinating cross-functional projects and programs.

Responsibilities

• Design, implement, and perform targeted monitoring to identify risks and support remediation.
• Support audit and readiness activities through risk-area identification and corrective actions.
• Oversee issue tracking and escalation in governance, risk, and compliance systems.
• Develop executive dashboards and reports summarizing compliance risks and metrics.
• Provide second-line oversight on preventive measures and corrective actions.
• Partner with business owners to identify, assess, track, escalate, and report compliance risks across Humana Pharmacy Solutions.
• Oversee CMS and Medicaid contract requirements across operations.

Skills

Analytical

Risk management

Project coordination

Communication skills

Attention to detail

Multitasking

Education

Bachelor’s degree

Job description

Humana Inc. is seeking a Senior Risk Management Professional to identify, assess, and mitigate compliance and operational risks within the Humana Pharmacy Solutions space.

You will partner with risk operations, vendor teams, and business owners to strengthen controls and reporting. You will design monitoring programs, support audit readiness, and develop executive dashboards to highlight risk trends and remediation progress, while navigating CMS and Medicaid requirements in a remote work