Humana - Chicago, IL
posted 4 months ago
Become a part of our caring community and help us put health first. The Enterprise Risk Lead is responsible for managing Fraud & Investigations and Privacy risks, including monitoring and assessing risk, managing metrics and reports, internal consultation, and reporting to leadership. This role will be responsible for assessing, monitoring and consulting on risks related to potential fraudulent activity that may be perpetrated against Humana or by Humana associates, managing the Enterprise Investigations Consortium (EIC) to maintain investigative standards throughout the enterprise, and will support the management of Privacy risk. The Enterprise Risk Lead is responsible for driving the strategy and program development for the Fraud risk tower and supporting the ERM Privacy Lead in maturing the Privacy risk towers. The Lead will be responsible for the following: Conducting the required annual Top Risk Assessment for Fraud, identifying and implementing targeted risk assessments of key processes to identify potential gaps that may increase residual risk. Serve as a consultant to internal business partners to help advise on risk related to business decisions, process development, control improvement, and organizational changes. Develop and manage key risk metrics and key performance metrics to effectively monitor and report on the residual risk and provide transparency to senior leaders. Lead and facilitate enterprise-level cross-functional committees such as the Enterprise Fraud, Waste & Abuse Committee, the Enterprise Investigations Consortium (EIC), and the Insider Threat Task Force. Develop and maintain trainings and awareness activities to increase risk awareness throughout the business. Lead or provide consultation on critical investigations requiring multiple investigative teams or rising to the level of a crisis event. Draft and maintain policies and standards governing Humana's fraud and investigations programs. The Enterprise Risk Lead works on problems of diverse scope and complexity ranging from moderate to substantial; exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision. The Lead uses independent judgment requiring analysis of variable factors and determining the best course of action.