Senior Risk Management Professional

Humana

. Support effective intake, assessment, and implementation of Medicare and PBM pharmacy regulatory guidance .

Posted 11/12/2026full-timeRemote • United StatesSenior💰 $86,300 - $118,700 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in coordinating and implementing regulatory guidance within Medicare and PBM pharmacy operations, ensuring compliance and effective risk management. Proficient in managing multiple priorities and collaborating with stakeholders to achieve timely and accurate implementation outcomes.

Highest-signal resume keywords

Regulatory ComplianceRisk ManagementCross-Functional CoordinationAnalytical Problem-SolvingMedicare Part D Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Regulatory ImplementationRisk Acceptance ManagementEvidence CollectionCompliance AssessmentProject Coordination

Soft Skills

Strong Communication SkillsAttention to DetailAbility to Work IndependentlyCollaborative TeamworkTime Management

Tools & Technologies

Microsoft OfficeExcelOutlookTeamsSharePoint

Industry Keywords

MedicarePBM OperationsHealthcare ComplianceRegulatory GuidanceCMS Guidance

About the role

Key responsibilities & impact

Support effective intake, assessment, and implementation of Medicare and PBM pharmacy regulatory guidance
Coordinate required responses, evidence, controls, and implementation activities
Validate high-ranked and major implementations for completeness and readiness
Manage Risk Acceptances for identified gaps or residual risks
Partner with key stakeholders to ensure guidance is implemented accurately and documented appropriately
Ensure implementations are completed within required timelines
Coordinate cross-functional regulatory implementations across pharmacy/PBM operations, Medicare, compliance, regulatory, legal, risk management, and other impacted business areas
Identify implementation gaps, escalate risks or barriers, and facilitate resolution with stakeholders
Maintain implementation decisions, supporting evidence, controls, validations, and Risk Acceptances

Requirements

What you’ll need

Bachelor’s degree OR 3+ years of experience in healthcare, regulatory compliance, risk management, pharmacy/PBM operations, Medicare, or a related field
Experience reviewing, assessing, or implementing regulatory, compliance, or business requirements
Ability to coordinate cross-functional implementations, projects, or initiatives involving multiple stakeholders
Ability to manage multiple priorities and time-sensitive deliverables simultaneously
Strong analytical and problem-solving skills, including identifying gaps, risks, and issues requiring follow-up or escalation
Strong written and verbal communication skills
Proficiency with Microsoft Office applications, including Excel, Outlook, Teams, and SharePoint
Preferred: Experience with Medicare Part D, CMS guidance, or Medicare regulatory requirements
Preferred: Experience with PBM or pharmacy regulatory/compliance requirements
Preferred: Experience in a health plan, PBM, pharmacy, or other highly regulated healthcare environment
Preferred: Experience collecting, reviewing, and maintaining regulatory implementation evidence, controls, and supporting documentation
Preferred: Experience validating or overseeing regulatory implementations
Preferred: Experience with Risk Acceptances, issue management, corrective actions, or other formal risk-management processes
Preferred: Experience using regulatory, compliance, governance, risk, or implementation tracking systems
Ability to work independently and collaboratively across multiple business areas in a highly regulated environment
Ability to manage multiple concurrent regulatory implementations with varying complexity, priority, and timelines
Comfort identifying implementation gaps, escalating risks or barriers, and facilitating resolution
Strong attention to detail
Comfort working in an environment where regulatory requirements, priorities, and timelines may change quickly
Minimum home internet speed of 25 Mbps download and 10 Mbps upload for home or hybrid employees
Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information

Benefits

Comp & perks

Bonus incentive plan based on company and/or individual performance
Medical, dental, and vision benefits
401(k) retirement savings plan
Paid time off
Company and personal holidays
Paid parental and caregiver leave
Short-term and long-term disability
Life insurance
Occasional travel to Humana offices for training or meetings