[Hiring] Associate Director, Risk Management @Humana

Role Description

The Associate Director, Risk Management identifies and analyzes potential sources of loss to minimize risk. This role requires a solid understanding of how organization capabilities interrelate across department(s).

The Associate Director estimates the potential financial consequences of an occurring loss and develops and implements controls and cost-effective approaches to minimize the organization's risks. Responsibilities include:

• Assessing and communicating information regarding business risks with functions across the organization.
• Supervising a team and working with HCPR Operations to ensure operational processes are compliant with appropriate regulations.
• Driving the culture of compliance within HCPR to maintain audit-ready everyday status.
• Coordinating, assigning, training, and ensuring competency in all audit-related functions – data production, speaking, driving, and research.
• Overseeing universe generation and metric reporting for all lines of business.
• Facilitating risk assessment discussions related to compliance issues and/or new guidance implementation.
• Supporting Medicaid prior authorization work from a compliance perspective.
• Developing departmental strategy as it relates to new initiatives or guidance.
• Reviewing change requests for IT systems for compliance to regulations and impacts to existing processes.
• Creating, reviewing, and/or analyzing processes, documentation, and data to identify any gaps around compliance with regulatory requirements.
• Providing support around Quality Events from a compliance/risk perspective.
• Creating executive-level dashboards to summarize compliance risks and key performance indicators.
• Building and maintaining key working relationships across Humana related to your assigned functional area.
• Responsible for team performance, development, and coaching.
• Developing and executing associate engagement planning.

Qualifications

• Bachelor's Degree.
• Experience with Prior Authorization, Compliance, or Risk Management.
• 2 or more years of people management experience.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

Requirements

• Self-provided internet service must meet a minimum download speed of 25 Mbps and an upload speed of 10 Mbps.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Occasional travel to Humana's offices for training or meetings may be required.

Benefits

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life insurance.
• Many other opportunities to support whole-person well-being.