Remote Risk Management Lead Audit & Compliance

Humana · Workfromhome, United States

Humana Inc. seeks a Claims Risk Management Lead to oversee investigations of alleged claim payment errors, support audits, and ensure compliance with contractual and operational requirements for VA CCN.

The role reports to the Director of Claims Risk Management and guides high-dollar claims review and remediation efforts. You will train staff, translate contract requirements into controls, develop implementation plans, and collaborate with internal teams and subcontractors to address audit