Risk Adjustment Compliance Principal

Humana

1d • $138,900 - $191,000 • Remote

About The Position

The Risk Adjustment Compliance Principal will support horizontal teams throughout the Risk Adjustment organization and the enterprise - including members from Actuarial, Government Affairs, and the Clinical organizations. The Principal will create engagement to evaluate risk adjustment policies and program changes proposed by CMS. Humana must improve its advocacy work on future risk adjustment methodology to support the long-term success and financial viability of the Medicare Advantage program. The Principal will also be an expert, supporting proactive evaluations of risk adjustment program policies and industry ideas. These evaluations will inform Humana's Government affairs and public policy team, along with risk adjustment leaders at Humana, of how proposed policies may improve Humana's insurance segment. Also, the Risk adjustment Compliance Principal will increase creative idea generation when considering the possibilities that CMS's Medicare Advantage Risk Adjustment program will undergo regarding future changes. You will be an important advisor to leaders at Humana, including the SVP of Risk Adjustment, Humana's Chief Actuary, and VP of Public Policy. You will support Humana to position themselves as an industry leader in influencing future Risk Adjustment policy and methodology through industry channels. The Risk Adjustment Compliance Principal will help prepare Humana for future Risk Adjustment changes to minimize impact to customer experiences and outcomes. You will report to Associate VP, Risk Adjustment Compliance and be apart of Humana's Risk Adjustment organization.

Requirements

• Bachelor's degree with at least 10 years of related experience
• 5+ years of project leadership
• Previous experience influencing policy and industry bodies
• Experience with Medicare Advantage bid process
• Medicare Risk Adjustment Knowledge
• Expert known outside of Humana for involvement in supporting Humana regulatory/compliance-focused work
• Knowledge of the healthcare environment and managed care

Nice To Haves

• Background Experience in previous compliance, policy, or government affairs teams
• Experience working with CMS

Responsibilities

• Evaluate and propose risk adjustment program policies and to communicate impacts to the enterprise's financial and business operations
• Inform and influence senior leaders on evaluation and influence of risk adjustment policies and methodologies while considering approach to influence industry to shape future risk adjustment policy
• Introduce solutions to complex risk adjustment problems that has impact on Humana's insurance segment and future risk adjustment policy
• Lead Humana to become a stronger in the industry to support future risk adjustment policy
• Support response efforts to CMS proposals, changes and requests for information.

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

What This Job Offers

• Job Type: Full-time
• Career Level: Senior