Program Manager, Risk

ArchWell Health is a new, innovative healthcare provider devoted to improving the lives of our senior members. We deliver best-in-class care at comfortable, accessible neighborhood clinics where seniors can feel at home and become part of a vibrant, wellness-focused community. Our members experience greater continuity of care, as well as the comfort of knowing they will be treated with respect by people who genuinely care about them, their families, and their communities.
The Risk Program Manager will play a critical role in risk mitigation, regulatory compliance, and occurrence management for our health care operations. Reporting directly to the VP of Compliance, this role will be responsible for risk assessment and mitigation, the occurrence reporting process, and claims reporting and management. The role will collaborate with enterprise support departments as well as operations to continuously improve patient safety and mitigate clinical risks.
Duties/Responsibilities:

• Coordinates the Clinical Risk Management Program to meet the needs of the organization.
• Manages the incident reporting system and process.
• Reviews and analyzes all occurrences for risk management, quality of care, regulatory and insurance concerns.
• Conducts, focused investigations, reviews and participates in analyses and the continuous improvement process.
• Manage professional and general liability carrier reporting and follow-up.
• Assists with litigation management.
• Assist providers with managing licensing board letters of inquiry and investigations.
• Create reports reviewing incidents for trends and process improvement.
• Collaborate with relevant departments to analyze incident data, identify trends, and develop strategies to prevent recurrence.
• Assists with health plan grievance process.
• Work closely with compliance regarding regulatory matters.
• Conduct regular risk assessments across various aspects of the organization, including clinical practices.
• Collaborate with departments to identify potential risks and develop mitigation plans.
• Stay up to date with industry regulations and standards related to healthcare risk management.
• Provide training and educational programs to colleagues on risk management, incident reporting and risk mitigation.
• Promote a culture of safety and risk awareness throughout the organization.
• Maintain detailed records.
• Create update and maintain risk management policies and procedures that outline the organization’s approach to managing risks.
• Ensure the organization complies with relevant laws, regulations and industry standards related to risk management and safety.
• Performs other related duties.

Required Skills/Abilities:

• Strong knowledge of healthcare regulations.
• Excellent communication, problem solving and interpersonal skills.
• Ability to collaborate with cross functional teams.
• Diligence and a commitment to promoting a culture of safety.
• Ability to assess potential risks to prioritize them based on their impact and likelihood.
• Strong analytical skills to collect and interpret data, perform risk analysis, and make data driven decisions.
• Proficiency in developing and guiding implementation of risk mitigation strategies.
• Ability to identify problems, analyze their root causes and develop creative solutions to mitigate or eliminate risk.
• Proficiency in crisis management and the ability to respond effectively to unexpected events or emergencies that pose a risk to the organization.

Education and Experience:

• Bachelor’s degree in nursing or related field.
• Master’s Degree of Juris Doctorate preferred.
• Certification in risk management preferred.
• Minimum of 5 years of experience in healthcare risk management or a related field

Embodies and serves as a role model of ArchWell Health’s Values:

• Be compassionate
• Strive for excellence
• Earn trust
• Show respect
• Remain resilient
• Do the right thing and do it with passion

ArchWell Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected classification.