Risk Management Lead

Become a part of our caring community The Risk Management Lead identifies and analyzes potential sources of loss to minimize risk. The Risk Management Lead works on problems of diverse scope and complexity ranging from moderate to substantial. Humana's Operational Risk Management organization seeks a Risk Management Lead to oversee the design, implementation, and maintenance of multiple dashboards aligned with CMS requirements for Part C Service Level Data Collection. This role focuses on initial determinations and appeals within the Medicare sector and CMS Program Audit spaces, ensuring data collected from delegated and vendor partners is aggregated with enterprise data to meet regulatory requirements. Additionally, this role will support our DSNP Reporting team, where appropriate in any dashboard requirements or development. Key Responsibilities: Develop and maintain technical specifications for dashboards that address CMS regulatory requirements. Collaborate with the IDEA (IT) team to design data marts supporting dashboard functionality and performance review. Provide support for ad-hoc reporting needs for business teams and regulatory partners. Build and refine delegate/vendor submission processes in collaboration with IT and other stakeholders. Engage with delegated/vendor partners to facilitate accurate and timely data submissions. Provide IT partners with comprehensive test cases for developed solutions and conduct User Acceptance Testing (UAT) to ensure requirements are fulfilled. Work with the Business Intelligence team to refresh and maintain existing dashboards. Migrate dashboards from legacy platforms to PowerBI. Develop and maintain detailed documentation outlining methodologies and processes supporting the dashboards.