Senior Director, Clinical Risk Management
IEHP
full-time
Posted on:
Location Type: Hybrid
Location: Rancho Cucamonga • California • United States
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Salary
💰 $220,043 - $302,536 per year
Job Level
About the role
- Provides strategic leadership and oversight for the development and implementation of the health plan’s clinical risk management program and plan
- Accountable for identifying, assessing, and mitigating risks that could impact organizational performance, regulatory compliance, and member safety
- Collaborates with executive leadership, operational teams, and regulatory agencies to ensure member safety, adherence to state and federal requirements, accreditation standards, and industry best practices
- Driving a culture of member safety and accountability across the organization
- Designing and implementing enterprise-wide risk management frameworks and protocols
- Ensuring compliance with all applicable regulations and accreditation standards
- Identifying emerging risks and leading proactive intervention strategies
- Building strong stakeholder relationships and providing transparent reporting to leadership and governing bodies
Requirements
- A minimum of ten (10) years of progressive experience in clinical risk management within a health plan or healthcare setting
- A minimum of three (3) years of proven leadership experience managing enterprise risk programs
- Bachelor's degree in nursing and/or related field from an accredited institution
- In lieu of the required degree, a minimum of eight (8) years of additional relevant work experience is required for this position
- A master’s degree in nursing or related field from an accredited institution is preferred
- Certified Professional in Patient Safety (CPPS) or other relevant certification preferred
- Possession of an active, unrestricted, and unencumbered Registered Nurse (RN) license issued by the California Board of Registered Nursing required
- Advanced knowledge of risk management principles, practices and techniques
- Knowledge of healthcare/health plan operations, regulations, and compliance requirements
- Demonstrated knowledge of healthcare laws and regulations, safety science, and patient safety best practices
- Knowledge of healthcare risk financing and health insurance principles
- Knowledge of health plan accreditation standards, such as NCQA
- Knowledge of healthcare quality improvement methodologies, such as Lean or Six Sigma
- Strong problem-solving skills to address complex challenges
- Mindset of innovation to continuously improve operations and processes while mitigating risks
Benefits
- Competitive salary
- State of the art fitness center on-site
- Medical Insurance with Dental and Vision
- Life, short-term, and long-term disability options
- Career advancement opportunities and professional development
- Wellness programs that promote a healthy work-life balance
- Flexible Spending Account – Health Care/Childcare
- CalPERS retirement 457(b) option with a contribution match
- Paid life insurance for employees
- Pet care insurance
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical risk managemententerprise risk programsrisk management principleshealthcare operationshealthcare regulationshealthcare lawshealthcare risk financinghealth plan accreditation standardsquality improvement methodologiespatient safety best practices
Soft Skills
strategic leadershipcollaborationstakeholder relationship buildingproblem-solvinginnovationaccountabilitytransparency in reporting
Certifications
Certified Professional in Patient Safety (CPPS)Registered Nurse (RN) license