Full Time Remote Risk Adjustment Coder Jobs in Miami, FL

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The Market Finance Lead is a necessary financial and strategic partner responsible for connecting market financial performance with operational effectiveness. You will analyze financial results, claims experience, use trends, contract performance, membership, and provider performance data to identify opportunities, influence decisions, and support market
growth and operational improvement.
You will will partner with regional leadership. The Market Finance Lead will also partner with actuarial, corporate finance, clinical, risk adjustment, market operations, provider engagement, hospitals, ancillary partners, sales/MarketPoint and value-based care providers. You will translate complex financial and operational data into meaningful recommendations, and action plans that improve performance across the market.

As the Market Finance Lead you will:

• Work directly with value-based providers to review financial performance, membership, cost and use trends, contractual results, and opportunities for improvement. Present on provider trends and opportunities for improvement directly with providers and senior leadership.

• Analyze market financials, claims data, utilization trends, membership movement, risk adjustment impacts, medical cost drivers, and provider contract performance.

• Evaluate provider and contract financials to identify cost-of-care opportunities, performance gaps, and areas for operational improvement.

• Be a strategic finance partner to regional and market leadership, providing insights that support operational, financial, and value-based care performance.

• Develop and deliver financial reporting dashboards, and executive-level summaries that performance trends, risks, and opportunities.

• Support budget development, forecasting, administrative planning, and financial performance reviews for the market.

• Lead financial analysis for strategic initiatives, including market optimization, value-based care performance, cost containment, and growth-related activities.

• Advise regional leadership on financial strategies and performance matters of significance.

• Address complex financial and operational issues.

• Build relationships with internal stakeholders and external provider partners to support collaboration, accountability, and performance improvement.

• Monitor company initiatives and assess financial and operational impacts across the market.

Use your skills to make an impact

Required Qualifications

• Bachelor's degree or higher

• 2 or more years of working with Value Based Contracts (VBC) and/or Value Based Providers (VBP)

• Experience developing methods and criteria for measuring and summarizing data for complex analyses

• Experience advising senior leadership on financial strategies

• 2 or more years of project leadership experience

• 1 or more years of SQL or other data related tools

• Knowledge of complex accounting and financial transactions for internal and external reporting

• 1 or more years experience leading and managing special projects that may necessitate cross-functional partnerships

Preferred Qualifications

• 3 or more years healthcare economics or value based performance analytics experience

• Experience in the Medicare Advantage bid process

• 3 or more years of experience in Service Fund reporting

• Experience managing a team

• Knowledge of complex accounting and financial transactions for internal and external reporting

• Master's Degree in Business Administration or a related field

• Project Management Professional (PMP)

• Certified Public Accountant

Additional Information

• Travel based on business needs

• 8am to 5pm EST or CST

HireVue

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Work at Home

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. Satellite, cellular and microwave connection can be used only if approved by leadership.

• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

#LI-BB1

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$104,000 - $143,000 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 07-10-2026
About Us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.