Associate VP Operational Risk Management - Group amp Military Segment

Profile

Description

As a company whose primary focus is on the well-being of its members, Humana is dedicated to shifting perceptions of the health insurance industry. We believe our role goes beyond that of a payer to that of a 'well-being partner' who will empower consumers to live a life that's healthy, active and rewarding. Success in these efforts ensures our ability to deliver on promises to key stakeholders.

The policy of Humana is to maintain an operational risk management function as a means of assisting the Management in assuring that appropriate risk management, control and governance processes are in place.

Responsibilities

The scope of work for the department:


Lead the Group Military and Specialty Segment Operational Risk Management processes and ensure no membership, customer satisfaction, or pretax goal for Specialty, Group Medical or Group Military is missed
Proactively identify and mitigate risks in a timely and holistic approach such that impact to stakeholders is minimized
Lead and operate GMS (Group Military and Specialty COVID response in order to meet Humana's objective of being a trusted partner to members, beneficiaries, providers, and associates
Lead GMS Risk & Compliance so that the objectives established by the Humana ERM (Enterprise Risk Management) Policy are met and key identified risks and mitigations are understood by leadership/operators
Leverage proactive risk identification tools (PInG, governance) for material new processes or initiatives i.e. Rating Platform Migration, Project Evidence
Develop and implement the strategy for the next phase of Operational Risk Management including defining new ways of early identification and prevention of potential risk issues


Accountability


The Associate Vice President of Group & Military Segment Operational Risk Management shall be accountable to the Group Military and Specialty Business Leadership team and the Management Team to:
Own risk mitigation playbook, running the underlying tools and processes of issues to report to Management Team. Monitor dashboards, ensuring risk management policies are adhered to and plan for business continuity issues.
Identify mitigation plan for Enterprise Task Force Trend Remediation in partnership with Employer Group Actuary, Trend Quantification and Projection, and Risk Management
Provide strategic program support and share mitigation strategy, reporting for short-term priorities
Identify long-term process controls
Lead process improvement initiatives focused on improving the customer experience, leveraging automation and driving reduced cycle time and increased NPS, while prioritizing and optimizing the portfolio
Ensure that the identified opportunities for budgeted administrative savings are realized, including reconciliation associated with segment-level stretch opportunities


Our Ideal Candidate

A passion/commitment to quality work is fundamental to this role. The ideal candidate will also embody:

Requirements:


Superior oral and written communication skills
Bachelor's degree required; CPA, MBA, JD and/or related professional credentials preferred
10 years' experience in risk, law, accounting, process, and/or regulatory experience. A minimum of 5 years of supervisory experience is required
Experience with a top consulting firm a plus
Advanced knowledge of and experience with manual and automated systems of internal control, including financial reporting, compliance, risk management and operational controls
Advanced knowledge of and experience with general systems and IT technical controls and risks
Strong project management skills with the ability to organize and manage multiple priorities
Possession of the highest professional and personal standards, unquestioned integrity and business ethics. Having a courage of convictions adhering to strong principles and values and holding others to the same level
Ability to work in a complex organization with clients at all levels of the enterprise
Talented in leading through influence, and to collaborate credibly and effectively with leadership across the organization


Scheduled Weekly Hours

40

Company info

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