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Humana Medicaid Risk Adjustment Program Delivery Lead in Rogers, Arkansas


The Medicaid Risk Adjustment Program Delivery Lead strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Medicaid Risk Adjustment Program Delivery Lead works on problems of diverse scope and complexity ranging from moderate to substantial.


The Medicaid Risk Adjustment Program Delivery Lead develops and leads programs designed to drive various internal and vended risk adjustment initiatives (retrospective and prospective) within the Medicaid line of business. Partners with leaders regarding implementation planning. Monitors, reviews and communicates results of programs. Advises executives to develop functional strategies on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision. Uses independent judgment requiring analysis of variable factors and determining the best course of action.

In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:

  • Medical Benefits

  • Dental Benefits

  • Vision Benefits

  • Health Savings Accounts

  • Flex Spending Accounts

  • Life Insurance

  • 401(k)

  • PTO including 7 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time

  • And more

Required Qualifications

  • Bachelor's degree or equivalent experience

  • 3 or more years of risk adjustment experience

  • 2 or more years of large project leadership experience

  • Strong knowledge of Microsoft Office XP products (Word, Excel, Access Powerpoint)

Preferred Qualifications

  • Master's Degree in Business Administration or a related field

  • Experience with Medicaid risk adjustment models (CDPS or ACG)

  • Knowledge and experience in a managed care environment

  • PMP certification a plus

  • Strong analytical skills

Additional Information

Interview Format

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

If you are selected for a first round interview, you will receive an email correspondence inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website.

Humana is more than an equal opportunity employer, Humana's dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our Humana roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin and all of the other fascinating characteristics that make us each uniquely wonderful.

Scheduled Weekly Hours