Senior Remote Clinical Risk Lead

Humana Inc; Salem (OR); Remote; USD 104,000 - 143,000; Full time

Benefits offered by this job

Bonus incentive plan

Medical benefits

Dental benefits

Vision benefits

401(k) plan

Job summary

Humana Inc is seeking a Clinical Risk Management Lead to oversee risk assessments and mitigation across the PCO, interfacing with clinical and business leaders to improve controls and governance. The role reports to the Associate VP, Risk Management and spans collaboration with CenterWell Senior Primary Care, Conviva, and MaxHealth, with travel as needed.

The ideal candidate holds a clinical degree with an active license, 5+ years of healthcare experience, and strong analytical and communication

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, patient care, and healthcare delivery.
• Develop and execute clinical risk management plans, including assessment of existing controls and recommendations for risk mitigation strategies.
• Partner with clinical leadership to evaluate risks and support the implementation of effective controls and corrective actions.
• Present findings, recommendations, and risk mitigation strategies to leadership and key stakeholders.
• Collaborate with Compliance, Legal, Privacy, Human Resources, Enterprise Health & Safety, and other internal teams on risk-related initiatives.
• Identify, document, and support resolution of business issues related to clinical practice and operational processes.
• Guide business and clinical partners through risk mitigation and corrective action planning.
• Conduct research, gather information, interview stakeholders, and evaluate clinical risk scenarios to support objective risk assessments.
• Monitor emerging risks, trends, and regulatory requirements affecting primary care and value-based care operations.
• Support continuous improvement efforts related to risk management frameworks, controls, and clinical governance processes.

Skills

Risk assessment

Analytical thinking

Communication

Problem solving

Stakeholder collaboration

Regulatory awareness

Education

Bachelor's degree in Nursing or related clinical discipline

Job description

Humana Inc is seeking a Clinical Risk Management Lead to oversee risk assessments and mitigation across the PCO, interfacing with clinical and business leaders to improve controls and governance. The role reports to the Associate VP, Risk Management and spans collaboration with CenterWell Senior Primary Care, Conviva, and MaxHealth, with travel as needed.

The ideal candidate holds a clinical degree with an active license, 5+ years of healthcare experience, and strong analytical and communication