Remote Senior Risk & Compliance Leader, Pharmacy Ops

Humana Inc; Salem (OR); Teletrabalho; USD 86 000 - 119 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Bonus incentive plan

Resumo da oferta

Humana Inc., CenterWell Senior Primary Care, is seeking a Senior Risk Management Professional to identify and mitigate risks across Pharmacy Operations. You will partner with Risk Operations, Humana Pharmacy Solutions, Humana Enterprise and vendor teams to identify, track, resolve, and report on compliance issues.

Success requires experience in compliance, risk management, or internal audit, plus pharmacy claims operations risk identification, remediation tracking, and regulatory reporting.

Qualificações

• Bachelor’s degree or 5+ years in PBM operations or risk management.
• 2+ years of pharmacy claims processing experience.
• Experience with compliance, risk identification, and reporting.
• Strong project management and cross-team collaboration.
• Ability to manage multiple tasks with attention to detail.
• Excellent organizational and communication skills.

Responsabilidades

• Design, implement, and perform targeted monitoring to identify risks.
• Support audit and readiness activities and remediation.
• Oversee issue tracking, remediation, and escalation.
• Develop executive dashboards and risk reporting.
• Provide second-line guidance on preventive and corrective actions.
• Partner with owners across Humana entities to report risks.
• Oversee CMS/Medicaid contract requirements across operations.

Conhecimentos

Risk management

Compliance

Internal audit

Project management

Data analysis

Pharmacy operations

Communication skills

Formação académica

Bachelor’s degree or equivalent

Ferramentas

Excel

Descrição da oferta de emprego

Humana Inc., CenterWell Senior Primary Care, is seeking a Senior Risk Management Professional to identify and mitigate risks across Pharmacy Operations. You will partner with Risk Operations, Humana Pharmacy Solutions, Humana Enterprise and vendor teams to identify, track, resolve, and report on compliance issues.

Success requires experience in compliance, risk management, or internal audit, plus pharmacy claims operations risk identification, remediation tracking, and regulatory reporting.