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Job Information

Humana Senior Risk Management Professional in Colorado Springs, Colorado

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 department's 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.

Required Qualifications

  • Bachelor's degree or equivalent work experience

  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

  • Working knowledge of CMS Regulatory Guidelines

  • 1+ years experience with Medicare and/or Medicaid and knowledge in regulations governing health care industries

  • Experience with the end to end audit process (audit preparation through issue resolution)

  • 3+ years of demonstrated experience with identifying/mitigating risks and improving business results

  • Experience with metric review and universe validations

  • Possess a solid understanding of care management/care coordination operations, technology, communications, and processes

  • Strong oral and written communication skills

  • Comprehensive knowledge of all Microsoft Office applications with proficiency working in Excel, PowerPoint, and Word

  • Strong business acumen: understands how the business works and has demonstrated collaboration across organizational teams

Preferred Qualifications

  • Registered nurse or social worker with care management/care coordination experience

  • Experience with Medicare and Medicaid contracts

Additional Information

Scheduled Weekly Hours

40

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