Risk Adjustment Strategic Partnership Lead

Become a part of our caring community and help us put health first
 As a Program Delivery Lead specializing in Risk Adjustment Strategic Partnerships, you will lead the development and execution of programs aimed at enhancing value-based relationships within the healthcare system. Operating within dynamic environments, you will drive initiatives that impact providers, members, and market leadership, fostering strategic alliances to improve quality metrics. Your expertise in risk adjustment and deep understanding of internal processes will enable you to navigate complexities and deliver impactful results. This role will involve close coordination with Group Medicare leadership to ensure collaborative insights and performance alignment.

The Program Delivery Lead spearheads the development of tailored programs that cultivate value-based relationships in healthcare. Collaborating closely with leadership, you will craft implementation plans and provide insights on program effectiveness. Your role extends to advising executives on segment-specific strategies, demonstrating independent judgment and decision-making prowess. Operating with minimal supervision, you will analyze multifaceted issues, identify optimal courses of action, and commit to problem-solving.

Additional Responsibilities:

• Design and implement reporting across the risk adjustment organization and with external partners (e.g., Kidney Team, Group Medicare).
• Support HQRI strategic engagements, representing risk adjustment across new member initiatives and PPO strategies.
• Possess strong financial acumen and understanding of risk adjustment mechanics to influence other lines of business.
• Foster relationships with providers and clinical leadership, internally and externally.
• Manage high-priority initiatives effectively, demonstrating a proactive approach and self-guided leadership.

Use your skills to make an impact
 

Required Qualifications

• 5 or more years of experience in the healthcare industry.
• 3 or more years of specific experience in risk adjustment.
• 2 or more years of project leadership experience.
• Proficiency in Microsoft Office Suite (Word, Excel, Access).
• Exceptional communication skills, both verbal and written.
• Proven ability in relationship building and collaboration.
• Passion for driving consumer and provider-centric improvements.
• Strong analytical acumen.

Preferred Qualifications

• PMP certification is a plus.
• Six Sigma Certification preferred.
• Knowledge and experience in the managed care environment.

Scheduled Weekly Hours

40

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.

$112,400 - $154,900 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.
About us
 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.