Risk Adjustment Compliance Principal

Overview Risk Adjustment Compliance Principal will support horizontal teams across the Risk Adjustment organization and the enterprise, including members from Actuarial, Government Affairs, and the Clinical organizations. The Principal will evaluate risk adjustment policies and program changes proposed by CMS to inform Humana’s Government Affairs and Public Policy team, risk adjustment leaders at Humana, and industry policy bodies. The role serves as an advisor to senior leaders such as the SVP of Risk Adjustment, Humana’s Chief Actuary, and VP of Public Policy, helping to position Humana as an industry leader in influencing future Risk Adjustment policy and methodology. Responsibilities Evaluate and propose risk adjustment program policies and communicate impacts to the enterprise’s financial and business operations. Inform and influence senior leaders on evaluation and influence of risk adjustment policies and methodologies while shaping industry policy. Introduce solutions to complex risk adjustment problems that impact Humana’s insurance segment and future policy. Lead Humana to become a stronger industry influencer on future risk adjustment policy. Support response efforts to CMS proposals, changes and requests for information. Required Qualifications Bachelor’s degree with at least 10 years of related experience. 5+ years of project leadership. Previous experience influencing policy and industry bodies. Experience with Medicare Advantage bid process. Medicare Risk Adjustment knowledge. Expert known outside of Humana for involvement in regulatory/compliance-focused work. Knowledge of the healthcare environment and managed care. Preferred Qualifications Background in compliance, policy or government affairs teams. Experience working with CMS. Work Location Work at Home Requirements: Home or Hybrid Home/Office employees must have self‑provided internet service meeting a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Employees should work from a dedicated space that protects member PHI/HIPAA information. Occasional travel to Humana offices for training or meetings may be required. Schedule 40 hours per week. Compensation Starting base pay: $138,900 – $191,000 per year, depending on geographic location and individual qualifications. Eligible for a bonus incentive plan based on company and/or individual performance. Benefits Humana offers medical, dental and vision benefits, 401(k) retirement savings plan, paid time off, paid parental and caregiver leave, short‑term and long‑term disability, life insurance and many other opportunities to support whole‑person well‑being. Equal Opportunity Employer Humana does not 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. Humana complies with all applicable federal civil rights laws and provides free language interpreter services. Application Deadline 07‑02‑2026 #J-18808-Ljbffr Humana Inc