5 days old

Senior Risk Management Professional - HCPR Special Projects

Humana
Louisville, KY 40207
Description The Senior Risk Management Professional identifies and analyzes potential sources of loss to minimize risk. The Senior Risk Management Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Responsibilities The Senior Risk Management Professional estimates the potential financial consequences of an occurring loss. Develops and implements controls and cost-effective approaches to minimize the organization's risks. Assesses and communicates information regarding business risks with functions across the organization. Begins to influence departments strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. As a Senior Risk Management Professional HCPR Compliance, you will work with HCPR Operations to ensure operational processes are compliant with appropriate regulations and report data that accurately reflects operations. The role is intended to support all lines of business, as needed. In this role you will: + Contribute to departmental strategy as it relates to business expansion, new initiatives or guidance + Create, review and/or analyze processes, documentation and data to identify any gaps specifically around compliance with regulatory requirements + Align existing processes across multiple functional areas into a consolidated compliant process + Analyze Knowledge Management scenarios for compliance to regulations + Create executive-level dashboards to summarize compliance risks and key performance indicators + Analyze data to identify root causes of noncompliance; work with HCPR Operational teams to develop and implement corrective action + Build and maintain key working relationships across Humana related to your assigned functional area + Recognize trends in non-compliant data and conduct training with appropriate operations staff to correct + Facilitate risk assessment discussions related to compliance issues and/or new guidance implementation Required Qualifications + Bachelor's degree or equivalent work experience + Minimum of 5+ years in either compliance/risk management, OR , pharmacy OR other applicable experience + Understanding of Medicare, Medicaid and Commercial Regulations + Project management experience + Analytical skills with the ability to identify the root causes + Advanced MS office suite experience Preferred Qualifications + Experience creating queries/pulling reports in SQL, Access + Risk management and compliance experience + Audit experience Scheduled Weekly Hours 40 About Us Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms when and where they need it. Our employees are at the heart of making this happen and thats why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first. Equal Opportunity Employer It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailbox_tas_recruit@humana.com for assistance. Humana Safety and Security Humana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailbox_tas_recruit@humana.com to validate the request. <>

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Posted: 2020-03-23 Expires: 2020-04-26

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Senior Risk Management Professional - HCPR Special Projects

Humana
Louisville, KY 40207

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