Program Delivery Principal - Risk Adjustment ...

Join our dedicated community and prioritize health The Program Delivery Principal plays a vital role in strategically developing and implementing programs aimed at enhancing value-based relationships among providers, members, or market leadership while improving quality metrics. This position offers strategic guidance to functional teams and requires advanced technical expertise. The focus of the Program Delivery Principal - Risk Adjustment Operations Transformation is to oversee and deliver technology solutions that optimize risk adjustment operations. Responsibilities include improving retrieval and coding processes, enhancing data management and sharing capabilities, and establishing scalable AI use cases throughout the risk adjustment lifecycle. The successful candidate will have a proven track record in leading matrixed teams, influencing decisions across functions, managing governance, and executing complex projects in a regulated healthcare environment. This role reports directly to the Associate VP, Risk Adjustment. Make a meaningful impact with your skills Provide vision, leadership, and guidance to multi-disciplinary program teams focused on transforming risk adjustment operations workflows. Develop and implement program strategies that enhance medical record retrieval, ensure coding accuracy, and promote data sharing among business and technology stakeholders. Explore and introduce innovative AI applications to improve outcomes in risk adjustment, including automation and predictive analytics. Manage program planning, execution, risk management, and delivery across multiple workstreams, ensuring adherence to organizational goals and compliance requirements. Build strong relationships with internal partners, technology vendors, and executive leadership to ensure successful program adoption. Lead program governance by establishing frameworks, performance metrics, and reporting processes. Drive initiatives for continuous improvement, effective change management, and best practices throughout risk adjustment operations workflows. Oversee program budgets, resources, and timelines to achieve intended outcomes. Prepare and present updates to senior and executive leadership. Continuously monitor and analyze industry trends, regulatory changes, and technological advancements in risk adjustment, data management, and AI to keep strategies competitive and compliant. Required Qualifications: Bachelor's degree in information technology, business administration, healthcare, or a related field. 5+ years of experience in delivering complex technology programs or projects, particularly in risk adjustment or healthcare operations. Experience with governance frameworks and executive-level reporting. Proven ability to lead and influence matrixed, cross-functional teams within a highly regulated environment. Strong understanding of risk adjustment processes, data management, and coding standards. Experience in designing and implementing technology solutions, including AI/ML applications in healthcare. Exceptional analytical, organizational, and communication skills. Preferred Qualifications: Master's degree in a related field. PMP, Agile, or Six Sigma certification. Previous experience with risk adjustment data retrieval, coding platforms, and AI-enabled healthcare solutions. Work-At-Home Requirements Must be able to provide high-speed DSL or cable modem for a home office. Employees working from home in California will receive compensation for their internet expenses. A minimum internet speed of 25x10 (25mpbs download x 10mpbs upload) is required. Satellite and wireless internet service is not permitted for this position. Must have a dedicated workspace to maintain confidentiality of member PHI / HIPAA information. Interview Process Our hiring process includes an innovative interviewing technology provided by HireVue, allowing a streamlined decision-making approach for our recruiters and hiring managers. Selected candidates will receive an invitation to participate in a recorded Voice Interview or SMS Text Messaging interview, anticipated to take around 10-15 minutes. Travel may be required occasionally to Humana's offices for training or meetings, despite the remote nature of the job. Scheduled Weekly Hours 40 Salary Range This range reflects a good faith estimate of starting base salary for full-time work (40 hours per week) as of posting. Compensation may vary based on location and individual qualifications. $138,900 - $191,000 per year This position is eligible for a bonus incentive plan based on individual and company performance. Benefits Overview Humana, Inc. and its subsidiaries offer competitive benefits that support overall well-being. Benefits are designed to promote personal wellness and informed healthcare decisions, acknowledging that life extends beyond work. Some benefits include medical, dental, and vision insurance, a 401(k) retirement plan, and generous time off, including paid leave for personal and parental needs. Application Deadline: 03-06-2026 About Us Humana Inc. (NYSE: HUM) is dedicated to putting health first for our teammates, customers, and company. Through our insurance services and CenterWell healthcare services, we help millions attain their best health by delivering timely care and services. These efforts enhance the quality of life for individuals in Medicare, Medicaid, families, individuals, military personnel, and the broader community. Equal Opportunity Employer Humana does not discriminate against any employee or applicant based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or veteran status. We are committed to affirmative action to employ and promote individuals with disabilities or protected veteran status, basing all employment decisions on valid job requirements. This policy applies to all employment actions at every level. Humana complies with 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.

Created: 2026-03-10