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Humana Risk Adjustment Administration 4 in Hempstead, New York


The Risk Adjustment Administration Representative 4 is responsible for obtaining accurate healthcare information from providers to ensure appropriate clinical care for members and maintenance of accurate payment levels. The Risk Adjustment Administration Representative 4 assumes ownership and leads advanced and highly specialized administrative/operational/transactional customer support duties that require independent initiative, analysis and judgment.


The Risk Adjustment Administration Representative 4 may conduct analysis and proper maintenance of data, provider or member outreach, and/or record retrieval for all risk adjustment campaigns. Decisions are regarding the daily priorities for assigned groups/territories and/or external vendors including coordinating work activities and monitoring progress, and often oversees work of others and/or is the primary administrative owner of a main process, program, product or technology. Works within broad guidelines with minimal oversight.

Daily responsibilities include, Manage, maintain and track ADHOC retrospective projects assigned.

Provide white glove retrieval process service to value based groups and providers/groups new to Humana

Required Qualifications

  • Up to 2 years of working within a Healthcare or Provider Setting

  • High School Diploma

  • ‚ÄčAt least 2 years of leadership experience

  • Up to 2 years of project management

  • Strong knowledge of Microsoft Office XP products (Word, Excel, Access)

  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

  • Strong written and verbal communication skills; strong analytical, organizational and time management skills

Preferred Qualifications

  • Associates degree or higher

Scheduled Weekly Hours