Director of Risk Adjustment – Quality Record Retrieval

🕒 4 days ago

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Logo of Humana

Humana

10,000+ employees

Founded 1961

⚕️ Healthcare Insurance

Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Lead and develop a national, fully remote workforce of 300 teammates, including frontline staff, supervisors, and managers • Oversee end-to-end retrieval operations, driving performance through data-informed decision-making, goal monitoring, and operational accountability • Drive continuous improvement through the evaluation and enhancement of processes, technology, and provider engagement strategies • Lead the implementation of operational, technology, regulatory, and organizational changes across a large, distributed workforce • Build trusted partnerships across Risk Adjustment, Stars, Interoperability, Market leadership, and other key stakeholders

🎯 Requirements

• 5+ years of leadership experience, including people leadership and large-scale initiatives • 3+ years of experience managing large operational processes with high-stakes outcomes • Demonstrated success leading teams and delivering results in dynamic, evolving business environments • Track record of driving measurable results through process improvement and data-driven insights • Best-in-class communication skills at all levels; experience articulating complex operations to senior levels (VP+) of leadership • Comfort making quick decisions based on quantitative and qualitative insights • Experience cultivating trust and collaboration across a matrixed organization

🏖️ 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 and many other opportunities

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