Humana Pharmacy Solutions, Inc.Hiring

Director of Risk Adjustment Regulatory Audits

  • Remote, worldwide
  • Full-time
  • Lead
  • Posted 13 days ago
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In one line

Remote leadership job running external risk adjustment audits, from taking them in to submitting records and improving the process.

About the role

The work centres on keeping audit outcomes strong and financial exposure low. That means tight operations, clear reporting and better tools for the audit workflow.

At a glance

Pay
Not stated in the posting
Remote scope
Remote, worldwide
Seniority
Lead
Employment
Full-time
Skills
Risk adjustment, Process improvement, Analytics, Performance reporting
Visa
No sponsorship
Posted
16 Oct 2026
Last checked
29 Oct 2026

What you will do

  • Set the strategy for external risk adjustment audits and see that they run well
  • Build reporting and tracking for every regulatory audit
  • Talk with regulators through the audit and make sure all records go in
  • Look for technology that speeds up and sharpens the audit workflow
  • Set goals, priorities, staffing and budgets for the team

What they look for

  • Five or more years leading projects and people
  • Eight to ten years in strategic operations and analytics, with process improvement and stakeholder influence
  • Five or more years running programs with metrics and performance reporting
  • Five or more years of process improvement and operations work

Nice to have

  • Experience dealing with external regulators and presenting to senior leaders

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Questions about this job

Is this a remote job, and where can I work from?

The posting lists it as remote with no single country named, so candidates from different countries can apply.

What does this job pay?

The posting does not state a salary, so there is no figure to quote.

What experience is needed?

It is a lead role. The posting asks for: five or more years leading projects and people; eight to ten years in strategic operations and analytics, with process improvement and stakeholder influence; five or more years running programs with metrics and performance reporting. Skills it names include Risk adjustment, Process improvement, Analytics, Performance reporting.

How do I apply with Keywordise AI?

Click Apply with Keywordise AI, create an account and upload your CV. Your CV and cover letter are written for this job from what you have really done, then Keywordise applies for you. Trial: 7 days, no card.

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Humana Pharmacy Solutions, Inc.Remote, worldwide
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