Clinical Risk Management Lead

This is a fully remote position, open to applicants in United States.

📋 Description

• Assist in clinical risk management initiatives throughout the Primary Care Organization by identifying, evaluating, monitoring, and addressing risks.

• Execute clinical risk evaluations pertaining to clinical operations, patient care, and healthcare delivery systems.

• Formulate and implement clinical risk management strategies.

• Review current controls and propose risk mitigation approaches.

• Collaborate with clinical leadership to establish effective controls and corrective measures.

• Share findings, recommendations, and risk mitigation strategies with leadership and stakeholders.

• Work collaboratively with Compliance, Legal, Privacy, Human Resources, Enterprise Health & Safety, and other internal teams.

• Recognize, document, and facilitate the resolution of business challenges related to clinical practices and operational processes.

• Guide business and clinical partners in risk mitigation and the planning of corrective actions.

• Perform research, collect data, interview stakeholders, and assess clinical risk scenarios.

• Track emerging risks, trends, and regulatory requirements that impact primary care and value-based care operations.

• Contribute to the ongoing enhancement of risk management frameworks, controls, and clinical governance processes.

• Act as a clinical subject matter expert on clinical risk management, control design, issue resolution, and regulatory considerations.

• Report to the Associate VP, Risk Management.

• Engage with leaders from CenterWell Senior Primary Care, Conviva, and MaxHealth.

⛳️ Requirements

• A bachelor's degree or higher in Nursing, Physician Assistant Studies, or a related clinical field.

• An active and unrestricted clinical license.

• Over 5 years of experience in clinical healthcare.

• Experience in collaborating with clinical leadership and interdisciplinary stakeholders.

• Strong skills in analysis, communication, problem-solving, and risk assessment.

• Ability to assess clinical processes, identify risks, and suggest feasible solutions.

• Experience in presenting recommendations and findings to leadership audiences.

• APRN or PA designation is preferred.

• Preferred experience of 3+ years in risk management, compliance, auditing, healthcare quality, patient safety, clinical operations, or similar fields.

• Preferred background in value-based care, population health, primary care, Medicare Advantage, or managed care environments.

• Knowledge of healthcare regulations, internal controls, clinical governance, and risk management frameworks is preferred.

• Familiarity with healthcare operational processes, quality improvement initiatives, and regulatory compliance programs is preferred.

🏝️ Benefits

• Bonus incentive plan based on company and/or individual performance.

• Medical, dental, and vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company and personal holidays.

• Paid parental and caregiver leave.

• Short-term and long-term disability coverage.

• Life insurance.

• Internet service requirements/support for home or hybrid home/office employees.

• Dedicated workspace to protect member PHI / HIPAA information.