Risk Management Lead
Humana
full-time
Posted on:
Location Type: Remote
Location: California • United States
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Salary
💰 $104,000 - $143,000 per year
Job Level
About the role
- Acts as a consultant to the Risk Adjustment team leaders
- Identify and analyze potential risks and sources of loss to evaluate business processes and drive improvements
- Focus on Project Management and is responsible for oversight of the Risk Adjustment Operations processes
- Develops and implements controls and cost-effective approaches to minimize risks
- Assess and communicate information regarding business risks with functions across the organization
- Advise executives to develop functional strategies on matters of significance
- Provide consultative services to drive efficient, effective, and compliant risk adjustment processes
Requirements
- 3 or more years of project leadership experience
- 2+ year of audit, compliance, and/or risk experience
- Applicable Bachelor's degree - Accounting, Finance, Business, Auditing, Actuarial
- Certified Internal Auditor, CPA or CPC strongly preferred
- Risk Adjustment knowledge
- Experience with risk adjustment provider data and reporting
- Auditing experience
- Familiarity with CMS Reimbursement models and claims/encounter submission processes
- Data analysis and dashboarding experience
- People leadership experience
Benefits
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
project managementrisk analysisdata analysisdashboardingauditingrisk adjustmentcompliancecost-effective approachescontrols implementationprovider data reporting
Soft skills
consultative servicescommunicationleadershipstrategic advisingorganizational skills
Certifications
Certified Internal AuditorCPACPC