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Humana

Sells Medicare health plans and runs senior clinics

Associate Vice President - Model & AI Governance

Risk & ComplianceConfirmed live in the last 24 hours
Full-timeRemote in USA

About the Job

Requirements

  • A bachelor's degree is required.
  • At least 15 years of progressive experience in risk management, model risk management, AI governance, technology risk, data governance, analytics, compliance, internal audit, or another discipline.
  • Significant experience leading enterprise-wide model governance, AI governance, responsible AI, or technology risk programs.
  • Demonstrated experience operating at an executive level within a complex, highly regulated organization.
  • Strong understanding of AI and machine learning technologies, generative AI, model development and validation, data governance, and technology risk.
  • Knowledge of emerging AI regulatory and governance frameworks and applicable healthcare regulatory requirements.
  • Strong understanding of enterprise risk management, internal controls, issue management, and risk appetite frameworks.
  • Demonstrated experience presenting complex risk, technology, analytics, and AI governance topics to executive leadership and Board-level audiences.

Responsibilities

  • Own and continuously enhance the enterprise model governance framework, including model identification, inventory, classification, risk tiering, development, validation, approval, implementation, monitoring, change management, retirement, and documentation.
  • Define model risk appetite, risk taxonomy, minimum control standards, governance requirements, and escalation thresholds.
  • Provide effective challenge over model development, validation, implementation, monitoring, and performance.
  • Oversee the enterprise model inventory and ensure appropriate ownership, accountability, documentation, and risk classification.
  • Establish standards for model validation, including conceptual soundness, performance, stability, data quality, bias, explainability, and ongoing monitoring.
  • Ensure appropriate governance over third-party and externally developed models.
  • Develop and oversee the organization’s Responsible AI framework and principles.
  • Establish governance standards addressing fairness, bias, transparency, explainability, accountability, privacy, human oversight, safety, security, and appropriate use of AI.
  • Establish processes for AI use-case risk intake, risk assessment, approval, monitoring, and ongoing oversight, working closely with other AI governance functions to simplify and streamline processes.
  • Develop standards for responsible use of generative AI, large language models, AI agents, automated decision-making, and other emerging technologies, partnering with other stakeholders to ensure cross-functional alignment.
  • Establish governance mechanisms to identify and address unintended consequences, model drift, hallucination, discrimination, explainability limitations, and other AI-specific risks.
  • Own the enterprise AI risk management framework and associated governance processes.
  • Establish governance requirements and oversight for the enterprise AI inventory, ensuring AI applications and use cases are appropriately inventoried, classified, risk-rated, assigned accountable ownership, and monitored throughout their lifecycle.
  • Develop AI risk assessments and approval requirements proportionate to the potential impact of technology.
  • Establish ongoing monitoring of AI performance, effectiveness, risk indicators, incidents, exceptions, and emerging threats.
  • Partner with cybersecurity, Privacy, Legal, Compliance, Data Governance, and Technology Risk to address AI-specific risks.
  • Establish governance for the use of external AI providers, foundation models, APIs, AI platforms, and third-party AI solutions.
  • Establish policies, standards, procedures, control requirements, and governance committees necessary to manage model and AI risk.
  • Define clear first-line ownership and second-line oversight responsibilities.
  • Develop, maintain, and monitor enterprise model and AI risk appetite metrics, tolerance thresholds, and key risk indicators to support enterprise risk reporting and decision-making.
  • Lead Model Risk and AI Risk Governance committees and provide regular reporting to executive management, Risk Committees, and Board Committees regarding model and AI risk exposure, emerging risks, policy compliance, significant incidents, exceptions, and risk trends.
  • Lead a hybrid team of internal associates and specialized external partners responsible for model validation, governance administration, AI risk assessments, monitoring, and assurance activities.
  • Promote a culture of responsible AI and sound model governance through training, awareness, stakeholder engagement, and enterprise-wide governance education programs.

Desired Qualifications

  • Healthcare experience is strongly preferred.

About the Company

Humana

Sells Medicare health plans and runs senior clinics

Humana sells health insurance paid for by government programs, chiefly Medicare Advantage plans that private insurers run for Americans 65 and older in place of traditional Medicare. It ranks among the largest Medicare Advantage insurers in the country and also runs Medicaid plans for low-income families in several states. Its CenterWell business operates senior primary care clinics, a mail-order pharmacy and home health services, so many members get care from a company the insurer owns. Medicare and states pay Humana a set monthly amount per member, and it keeps the difference between those payments and members' medical costs. Humana was founded in 1961 as a nursing home company and is based in Louisville, Kentucky.

Company size
10,001+
Company stage
IPO
Headquarters
Louisville, KY
Founded
1961

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