Senior Risk Management Professional - PCO Compliance and Risk Management

Profile

Job Information

Humana

Senior Risk Management Professional - PCO Compliance and Risk Management

in

Louisville

Kentucky

Description

The Primary Care Organization (PCO), is looking for high potential candidates who are looking to accelerate their career development and contribute to driving disruption in the health care industry. The PCO provides primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, Missouri, Nevada, North Carolina, South Carolina and Texas. The PCO has a strong emphasis on senior-focused primary care for members of Medicare Advantage health plans and is committed to providing personalized, high-quality primary care combined with an excellent patient experience.

At PCO we want to help those in the communities we serve, including our associates, lead their best lives. We support our associates in becoming happier, healthier, and more productive in their professional and personal lives. We promote lifelong well-being by giving our associate fresh perspective, new insights, and exciting opportunities to grow their careers. Our culture is focused on teamwork and providing a positive and welcoming environment for all.

We have over 215 clinics nationwide and counting - come join us.

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 Compliance - PCO Compliance and Risk Management solves complex business problems and provides innovative solutions using operational data to identify valuable business insights, drive innovation, strategy and efficiencies. The Senior Compliance Professional works on problems of diverse scope and complexity ranging from moderately complex to complex. Build new capabilities and expand on existing capabilities leveraging a diverse set of tools including M365 Power Platform. Use data and creative solutions as the catalysts for improving compliance and minimizing risk within the PCO.

To be successful in this role, you need to be comfortable analyzing data, eager to accept new challenges that require innovative thinking, and comfortable aiding others in adopting new and different solution approaches.

Responsibilities

The Senior Compliance Professional - PCO Compliance and Risk Management is responsible for developing workflow and data visualization strategies, manages tools, technologies, applications and practices used to generate, collect, store, integrate, analyze, and present an organization's data in order to create insightful and actionable business information and support operational solutions.

Influence and support development of workflow solutions and associated operational data collection and reporting for a wide range and continually updated list of topics and subject matters

Drive development of dashboards, reports leveraging operationally-generated data

You will collaborate with cross functional team and identify most impactful solution needs aligned with the organizational strategy

Exercises independent judgment and decision making on complex issues regarding job duties and related tasks

Uses independent judgment requiring analysis of variable factors and determining the best course of action

Builds relationships with teammates and business leaders, collaborates and negotiates with cross functional business units and establishes effective operationally-scalable business solutions

Establishes and maintains data repositories and their inputs when needed

Required Qualifications

This is a Remote Opportunity - Candidates can live anywhere in the United States

Bachelor's Degree in computer science, engineering, computer science, statistics, mathematics or related field

3 years of combined experience in technical or data analytics and/or healthcare compliance, risk management, or related areas

Experience working with clinical, non-clinical, and operational data

Experience creating and/or improving solutions for various healthcare or compliance sectors

Experience using SharePoint and Power Platform tools such as Power Automate, Power Apps, and Power BI to design efficient and effective solutions to address business needs

Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction

Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs

Proficiency in verbal/written communication to senior and executive leadership

Must be passionate about contributing to improving health outcomes and focused on continuously improving customer experiences

Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required.

Preferred Qualifications

5 or more years of technical and/or healthcare data analytics, healthcare compliance, or relate experience

Bilingual in English and Spanish preferred, but not required

Advanced understanding in healthcare related operational data

Experience developing solutions for a provider organization

Additional Information

This is a Remote Opportunity - Candidates can live anywhere in the United States!

Travel:

Up to 10%, This may include travelling outside the state of residence.

For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to: Provide proof of full vaccination OR

Commit to weekly testing, following all CDC protocols, OR

Provide documentation for a medical or religious exemption consideration. This policy will not supersede state or local laws. Requests for these exemptions should be submitted at least 2 weeks prior to your scheduled first day of work.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com