Risk Program Delivery Professional

The In-Office Provider Programs organization within Risk Adjustment delivers products that help physicians provide optimal patient care and improve the accuracy of clinical documentation. Its portfolio includes both in-house and vendor solutions, with a focus on expanding analytics-driven and interoperable capabilities.

The Senior Program Delivery Professional is responsible for execution and operational performance outcomes for Provider Programs. This role handles moderately complex to complex assignments that require in-depth analysis of situations, data, and variable factors.

The Senior Program Delivery Professional implements, monitors, and continuously improves program operational processes. This role evaluates existing business processes and develops sustainable, repeatable, and measurable improvements. Overseeing documentation, design, and implementation of both current and new processes for the Provider Programs operational area.

- Collects and analyzes data to develop and recommend business practices and procedures that improve the customer experience, support compliance, and increase efficiency. - Leads and oversees business process improvement initiatives, including cross-functional, end-to-end lifecycle documentation and improvement, such as product and performance lifecycles. - Supports, leads, and drives key organizational initiatives, including retrospective lessons learned and cross-functional collaboration opportunities. - Ensures process and procedure documentation is standardized and accurate across programs. - Develops, reviews, and approves program education/materials - Supports operating discipline, including rollout, adoption, and ongoing departmental review of enterprise support frameworks. - Supports Provider Programs financial management, including program administration, claims management, and departmental administrative expenses.

- 5+ years of experience in program delivery, operations, business process improvement, or related operational roles. - 2+ years of experience analyzing operational data and using findings to recommend process, compliance, customer experience, or efficiency improvements. - 2+ years of experience documenting, standardizing, or improving business processes across cross-functional teams or programs. - Experience using Microsoft Office tools, including Excel, PowerPoint, Outlook, and Teams, to manage reporting, documentation, communication, and stakeholder updates. - Experience with departmental finance activities and processes (budgeting, forecasting, invoicing, reconciliation, planning, etc..)

- Bachelor's degree in Business Administration, Health Care Administration, Operations, Finance, or a related field; master's degree preferred. - Experience applying Lean, Six Sigma, or other process improvement methodologies to improve operational efficiency, quality, or performance outcomes. - Experience supporting financial management activities, including budgeting, expense tracking, claims management, reporting, or program administration. - Experience in operational program management, business operations, or process execution within a matrixed or cross-functional environment. - Project Management Professional (PMP) certification or equivalent project/program management credential preferred. - Knowledge of health care, managed care, provider programs, risk adjustment, or clinical documentation workflows. - Strong analytical skills, including the ability to interpret data, identify trends, and translate insights into actionable business recommendations.

Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$86,300 - $118,700 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.

Among our benefits, Humana provides 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.

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large.

Learn more about what we offer at Humana.com and at CenterWell.com.

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.

This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.