Healthcare Risk Management Professional - Remote - Humana - Louisville, KY

The Healthcare Risk Management Professional identifies and analyzes potential sources of loss to minimize risk. The Risk Management Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Responsibilities The Healthcare Risk Management Professional contributes to the success of Humana’s business strategy by supporting risk and compliance initiatives across the Resolution Team across various lines of business. Participates in external or internal Compliance audits and remediation. Collaborates with operational teams to develop and implement controls and approaches to minimize the organization's risks. Assesses and communicates information regarding business risks with functions across the organization. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.
Required Qualifications Bachelor’s Degree or equivalent Legal/Compliance experience Proficient with MS Excel and PowerPoint Minimum 2+ years of Healthcare experience OR experience working at a Consulting Firm (ie. Deloitte, McKenzie, etc.) supporting a Healthcare company Previous experience with a Medicare Health Plan, Medicare Contractor or Independent Review Entity (IRE/QIC) Demonstrated Data Analysis skills Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is required Must ensure designated work area is free from distractions during work hours and virtual meetings Preferred Qualifications Grievance and Appeals experience Microsoft Access Knowledge of Federal and State Healthcare Regulations Scheduled Weekly Hours 40

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