Senior Director, Clinical Risk Management
Inland Empire Health Plans, Rancho Cucamonga, California, United States, 91739
What you can expect!
Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!
Reporting to the Chief Quality Officer, the Senior Director of Risk Management provides strategic leadership and oversight for the development and implementation of the health plan’s clinical risk management program and plan. This role is accountable for identifying, assessing, and mitigating risks that could impact organizational performance, regulatory compliance, and member safety. The Senior Director 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.
Key areas of responsibility include:
Organizational Leadership & Culture – Driving a culture of member safety and accountability across the organization.
Strategy & Program Development – Designing and implementing enterprise-wide risk management frameworks and protocols.
Compliance & Regulatory Oversight – Ensuring compliance with all applicable regulations and accreditation standards.
Risk Monitoring & Mitigation – Identifying emerging risks and leading proactive intervention strategies.
External Relations & Reporting – Building strong stakeholder relationships and providing transparent reporting to leadership and governing bodies.
Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.
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
Education & Requirement
Required:
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
Required:
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. This experience is in addition to the minimum years listed in the Experience Requirements above
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
Key Qualifications
Must have a valid California Driver’s license
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 knowledge of healthcare laws and regulations, such as HIPAA and HITECH
Strong problem-solving skills to address complex challenges
Strong communication and interpersonal skills, with the ability to interact with all levels of the organization
Mindset of innovation to continuously improve operations and processes while mitigating risks
Ability to assess and mitigate risks for the organization
Ability to effectively communicate risk management concepts to non-technical stakeholders
Ability to build and maintain positive relationships with internal and external stakeholders
Ability to analyze data to identify trends, make recommendations and drive decision-making
Ability to adapt to changing priorities, requirements, business environments and organizational needs
Start your journey towards a thriving future with IEHP and apply TODAY!
#J-18808-Ljbffr
Reporting to the Chief Quality Officer, the Senior Director of Risk Management provides strategic leadership and oversight for the development and implementation of the health plan’s clinical risk management program and plan. This role is accountable for identifying, assessing, and mitigating risks that could impact organizational performance, regulatory compliance, and member safety. The Senior Director 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.
Key areas of responsibility include:
Organizational Leadership & Culture – Driving a culture of member safety and accountability across the organization.
Strategy & Program Development – Designing and implementing enterprise-wide risk management frameworks and protocols.
Compliance & Regulatory Oversight – Ensuring compliance with all applicable regulations and accreditation standards.
Risk Monitoring & Mitigation – Identifying emerging risks and leading proactive intervention strategies.
External Relations & Reporting – Building strong stakeholder relationships and providing transparent reporting to leadership and governing bodies.
Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.
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
Education & Requirement
Required:
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
Required:
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. This experience is in addition to the minimum years listed in the Experience Requirements above
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
Key Qualifications
Must have a valid California Driver’s license
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 knowledge of healthcare laws and regulations, such as HIPAA and HITECH
Strong problem-solving skills to address complex challenges
Strong communication and interpersonal skills, with the ability to interact with all levels of the organization
Mindset of innovation to continuously improve operations and processes while mitigating risks
Ability to assess and mitigate risks for the organization
Ability to effectively communicate risk management concepts to non-technical stakeholders
Ability to build and maintain positive relationships with internal and external stakeholders
Ability to analyze data to identify trends, make recommendations and drive decision-making
Ability to adapt to changing priorities, requirements, business environments and organizational needs
Start your journey towards a thriving future with IEHP and apply TODAY!
#J-18808-Ljbffr