Description

Become a part of our caring community and help us put health first
The Program Delivery Principal strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Program Delivery Principal provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience.

The Program Delivery Principal - Risk Adjustment Operations Workflow Transformation is responsible for the strategic oversight and delivery of technology solutions that drive the effectiveness and efficiency of risk adjustment operations. This role will focus on delivering solutions to optimize retrieval and coding processes, enhance data handling and sharing capabilities, and establish scalable AI use cases across the risk adjustment lifecycle. The ideal candidate will have demonstrated experience leading matrixed teams, influencing cross-functional decisions, driving governance, and delivering complex initiatives within a regulated healthcare environment. This position reports to the Associate VP, Risk Adjustment.

Use your skills to make an impact

Key Responsibilities:

• Provide vision, leadership, and direction for multi-disciplinary program teams focused on risk adjustment operations workflow transformation.
• Develop and execute program strategies that optimize medical record retrieval, coding accuracy, and data sharing across business and technology stakeholders.
• Identify and implement innovative AI use cases to improve risk adjustment outcomes, including automation, predictive analytics, and process optimization.
• Oversee program planning, execution, risk management, and delivery across multiple workstreams, ensuring alignment with organizational goals and compliance standards.
• Cultivate strong relationships with internal partners, technology vendors, and executive leadership to drive consensus and successful program adoption.
• Lead program governance, including the establishment and execution of frameworks, performance metrics, and reporting processes.
• Drive continuous improvement initiatives, change management, and best practices across all facets of risk adjustment operations workflow.
• Manage program budgets, resources, and timelines to achieve desired outcomes.
• Prepare and deliver presentations and updates to senior and executive leadership.
• Proactively monitor and evaluate emerging industry trends, regulatory changes, and technological advancements-particularly in risk adjustment, data management, and AI-ensuring program strategies remain innovative, competitive, and aligned with best practices and compliance requirements.

Required Qualifications:

• Bachelor's degree in information technology, business administration, healthcare, or related field.
• 5+ years of experience delivering complex technology programs or projects, preferably within risk adjustment or healthcare operations.
• Demonstrated experience with governance frameworks and executive-level reporting.
• Proven ability to lead and influence matrixed, cross-functional teams in a highly regulated environment.
• Strong understanding of risk adjustment processes, data management, and coding standards.
• Experience in the design and delivery of technology solutions, including AI/ML applications in healthcare.
• Excellent analytical, organizational, and communication skills.

Preferred Qualifications:

• Master's degree in a related field.
• PMP, Agile, or Six Sigma certification.
• Prior experience with risk adjustment data retrieval, coding platforms, and AI-enabled healthcare solutions.

Additional Information:

Work-At-Home Requirements

• WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
• A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
• Satellite and Wireless Internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

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
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$138,900 - $191,000 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: 03-13-2026
About us
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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.
Requisition #: R-404361

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