Job Details

Become a part of our caring community and help us put health first

The Director, Home Health Risk Management identifies and analyzes potential sources of risk, proactively ensuring controls and processes are in place to reduce risk. The Director, Home Health Risk Management requires an in-depth understanding of how organization capabilities interrelate across the Home Health segment.

The Director of Risk Management for Home Health will be responsible for development and implementation of controls and cost-effective approaches to minimize risks to the organization as well as estimating the potential consequences of risks. Assesses and communicates information regarding business risks with functions across the organization. Their focus will be on CenterWell risk assessments, issue management, auditing and monitoring. Areas of oversight will include CenterWell Home Health, OneHome, as well as new growth initiatives.

This role requires an in-depth understanding of Home Health in a Value Based Care environment and how organization capabilities interrelate across segments and with the Plan side of Humana. This individual will be responsible for assessing and communicating information regarding business risks with functions across the organization at the Vice President level. Decisions are typically related to the implementation of new/updated programs or large-scale projects for CenterWell Home Health, supporting technical/operational procedures and processes, new regulatory or compliance regulation, evaluation and implementation of key controls, drives goals and objectives, improves performance, and provides input into strategy. This individual will lead a team of 5 total associates.

Use your skills to make an impact

Key Responsibilities

• Focus on risk and compliance strategies for home health, telehealth, data privacy, and payor agnostic experiences.
• Payor contract compliance.
• Oversees specialized proactive risk assessments for large financially impactful or business critical projects, business integrations as well as other risk tools such as lessons learned reviews.
• Partnerships across Integrated Health, Reporting, Marketing, and operational partners to ensure compliance with: Privacy, Security, and data sharing policies, Federal & State Laws, CHAPs certification requirements, and CMS regulations as applicable.
• Establish an annual oversight workplan for areas of oversight (CenterWell Home Health & OneHome).
• Monitor teams progression to the workplan and ensure the quality of workplan items conducted by the team.
• Issues management & resolution for areas of oversight, drive solutions to resolve issues.
• Facilitation of discussions related to risk with AVP/VP level individuals.
• Drive clear and open communication across the Home Health organization and key partners.
• Continuously improve the Risk Management processes to enhance efficiency and effectiveness and reduce overall volume of issues.
• Stay abreast of risk management trends and best practices within Humana and externally to incorporate better practices.
• Partner with leaders across CenterWell to ensure consideration of regulatory guidance, patient, financial, and associate risks in key initiatives and decisions.
• Facilitate conversations across Home Health leaders to drive resolution of issues and improvement of Quality.
• Train team on risk management processes to enable them to be successful.

Required Qualifications

• Bachelor's Degree.
• 8 or more years of technical experience in the Home Health space.
• 5 or more years of management experience.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

Preferred Qualifications

• Master's Degree.
• 5 or more years of regulatory compliance or risk management experience.

Interview Format

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Travel

While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

$150,000 - $206,300 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline

01-04-2026

Equal Opportunity Employer

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.

Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options