Risk Management Lead

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The Risk Management Lead identifies and analyzes potential sources of loss to minimize risk. The Risk Management Lead works on problems of diverse scope and complexity ranging from moderate to substantial.

Humana's Operational Risk Management organization seeks a Risk Management Lead to oversee the design, implementation, and maintenance of multiple dashboards aligned with CMS requirements for Part C Service Level Data Collection. This role focuses on initial determinations and appeals within the Medicare sector and CMS Program Audit spaces, ensuring data collected from delegated and vendor partners is aggregated with enterprise data to meet regulatory requirements. Additionally, this role will support our DSNP Reporting team, where appropriate in any dashboard requirements or development.

Key Responsibilities:

• Develop and maintain technical specifications for dashboards that address CMS regulatory requirements.

• Collaborate with the IDEA (IT) team to design data marts supporting dashboard functionality and performance review.

• Provide support for ad-hoc reporting needs for business teams and regulatory partners.

• Build and refine delegate/vendor submission processes in collaboration with IT and other stakeholders.

• Engage with delegated/vendor partners to facilitate accurate and timely data submissions.

• Provide IT partners with comprehensive test cases for developed solutions and conduct User Acceptance Testing (UAT) to ensure requirements are fulfilled.

• Work with the Business Intelligence team to refresh and maintain existing dashboards.

• Migrate dashboards from legacy platforms to PowerBI.

• Develop and maintain detailed documentation outlining methodologies and processes supporting the dashboards.

• Communicate up-to-date regulatory requirements to delegated/vendor partners, document their compliance, and report findings to leadership.

• Ensure transparency for enterprise stakeholders regarding identified issues through dashboards.

• Maintain accurate lists of delegated/vendor partners for market and compliance stakeholders.

• Fulfill monthly and quarterly reporting obligations.

• Support data validation audits and respond to regulatory inquiries.

Use your skills to make an impact

Required Qualifications:

• Bachelor's degree.

• Experience working with large datasets in an enterprise setting.

• Data Analytics skills (preferably with Business Intelligence tools)

• At least 5 years of Business Intelligence experience.

• Demonstrated ability to collaborate with product, business, and technical stakeholders to deliver effective solutions.

• 1+ years of experience working with delegated/vendor partners in some facet, such as audits, contractual negotiations, etc.

• Data Analytics skills (preferably with Business Intelligence tools)

Preferred Qualifications:

• Knowledge of Medicare regulatory requirements.

• Proven track record in leading technology-focused initiatives.

• Background in regulatory audit processes.

• PMP Certification preferred

• 1+ years of experience working with delegated/vendor partners in some facet, such as audits, contractual negotiations, etc.

Additional Information:

• Occasional travel to Humana offices may be required for training or meetings.

• Scheduled weekly hours: 40

• This role is not eligible for work visa sponsorship.

To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.

• Satellite, cellular and microwave connection can be used only if approved by leadership.

• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from [email protected] with instructions on how to add the information into your official application on Humana's secure website.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$104,000 - $143,000 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities.

Application Deadline: 05-12-2026

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at?Humana.com?and at?CenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our