Jobs / United States / Humana INC
VP, Clinical Policy and Risk Management
Humana INC · 🇺🇸 Remote Nationwide · Remote
Sponsorship verdict
Sponsorship possible
One solid signal, not two — worth applying, and worth asking about sponsorship early.
- Employer is on a government sponsor recordThe US Department of Labor certified 260 H-1B/E-3 labor condition applications for this employer between Oct 2025 and Jun 2026 (latest Jun 2026) — the step every H-1B hire needs first. USCIS also records 130 H-1B approvals in FY2023. Source: LCA disclosure data (US Department of Labor (OFLC)).
- The posting doesn’t mention sponsorshipSilence isn’t a refusal — ask the recruiter before investing much time.
- No salary bar for this routeH-1B has no fixed salary bar: the employer must pay at least the prevailing wage for the role and area. Cap-subject employers enter a lottery weighted by wage level. Source: https://www.federalregister.gov/documents/2025/12/29/2025-23853/weighted-selection-process-for-registrants-and-petitioners-seeking-to-file-cap-subject-h-1b, rules effective 2026-02-27.
- What Humana INC paid sponsored hires in similar roles3 certified filings for “Senior Corporate Strategy Analyst” (Management Analysts) in VA: $130k–$144k, median $131k. Most were filed at wage level I (67%) — 1 lottery entry, ≈15% projected selection odds for cap-subject employers. Source: US Department of Labor LCA disclosure data (Oct 2025 – Jun 2026).
- Last confirmed live 3 days agoWhen a source last listed this job as open.
US H-1B: cap-subject employers enter a lottery weighted by wage level — Level I gets 1 entry, Level IV gets 4 (DHS projected selection odds ≈15% at Level I to ≈61% at Level IV). Universities and non-profit research employers are cap-exempt. The $100,000 fee for new petitions from abroad is currently blocked by a court order (appeal pending).
A verdict summarises public evidence; it is not legal advice and never a guarantee — the employer and the immigration authority decide. Sign in to factor in where you can already work.
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Sponsor Radar — Humana INC
The US Department of Labor certified 260 H-1B/E-3 labor condition applications for this employer between Oct 2025 and Jun 2026 (latest Jun 2026) — the step every H-1B hire needs first. USCIS also records 130 H-1B approvals in FY2023. Source: LCA disclosure data (US Department of Labor (OFLC)).
Past sponsorship or register membership never guarantees sponsorship for this vacancy or for you. Full Sponsor Radar for Humana INC →
About the role
Become a part of our caring community Humana maintains a robust clinical risk management function to ensure effective risk mitigation, control, and governance processes across Care Management and Utilization Management. The mission of the Medicare and Medicaid Operational Risk Management Department is to partner with CM/UM teams to drive operational compliance, member access to care, and efficiency, while proactively identifying and managing risks related to care and utilization management. Position Overview The Vice President, Clinical Policy and Risk Management will oversee a department comprising 7 direct reports and 250 associates that lead CM/UM Risk Management, UM and CM audit teams, and policy governance. This role reports directly to the Senior Vice President – Clinical Operations. Department Scope & Responsibilities • Identify, assess, and report operational and clinical risks within CM/UM processes to appropriate governance structures. • Monitor CM/UM compliance and operational metrics, ensuring escalation and resolution of any issues impacting member care or regulatory compliance. • Track, interpret, and implement CMS Federal and Medicaid State regulations impacting CM/UM, ensuring timely and complete adoption. • Support regulatory audits with emphasis on CM/UM compliance and facilitate remediation where necessary. • Lead risk mitigation efforts related to care management and utilization management, including maturity assessments and oversight of issues and opportunities. • Oversee CM/UM business continuity and work across leadership to resolve any IOPs administered. • Foster quality and continuous improvement within CM/UM control processes, ensuring alignment with policies, standards, and applicable laws. • Address legislative and regulatory issues with potential impact on CM/UM operations, including fraud risk identification and mitigation. • Partner closely with Legal, Compliance, Regulatory Affairs, and business leaders to assess emerging regulatory and legal risks, interpret legislative requirements, support audit and litigation readiness activities, and ensure CM/UM policies, controls, and operational practices align with applicable federal and state laws. Use your skills to make an impact Key Candidate Qualifications • Bachelor’s degree required; MBA preferred • Maintains an active, unrestricted clinical license in the applicable discipline (e.g., RN, LCSW, LPC, LMFT, PharmD, MD/DO, or other relevant clinical credential) and demonstrates the ability to apply clinical expertise, professional judgment, and regulatory knowledge to support business, operational, and member outcomes • Extensive experience (10+ years) in CM/UM risk management, regulatory compliance, process improvement, or related fields, with 6 plus years in leadership roles. • Advanced knowledge of CM/UM operational controls, risk mitigation strategies, and regulatory requirements for Medicare and Medicaid. • Demonstrated expertise in internal controls, clinical and operational risk management, and IT technical controls within CM/UM environments. • Exceptional project management skills, integrity, and business ethics. • Ability to collaborate with stakeholders across the enterprise and influence outcomes in complex, matrixed environments. • Excellent communication skills and executive presence. Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Hum