Clinical Risk Management Lead

Job not on LinkedIn

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $104k - $143k / year

⏰ Full Time

🟠 Senior

🔒 Insurance

👻 Ghost score 0%

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CenterWell Senior Primary Care

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

CenterWell Senior Primary Care is a healthcare provider focused on delivering personalized primary care to senior citizens. The company emphasizes a comprehensive and holistic approach to healthcare, addressing the physical, social, and emotional needs of older adults. As part of its service offerings, CenterWell includes home health services and pharmacy support to complement its senior primary care. The organization is committed to offering stability, inclusive benefits, and career growth opportunities for its employees while maintaining a culture of mutual respect and mindfulness. CenterWell is a brand under the larger healthcare entity, Humana.

📋 Description

• Support clinical risk management activities across the Primary Care Organization by identifying, assessing, monitoring, and mitigating risks • Conduct clinical risk assessments related to clinical operations, patient care, and healthcare delivery • Develop and execute clinical risk management plans • Assess existing controls and recommend risk mitigation strategies • Partner with clinical leadership to implement effective controls and corrective actions • Present findings, recommendations, and risk mitigation strategies to leadership and stakeholders • Collaborate with Compliance, Legal, Privacy, Human Resources, Enterprise Health & Safety, and other internal teams • Identify, document, and support resolution of business issues related to clinical practice and operational processes • Guide business and clinical partners through risk mitigation and corrective action planning • Conduct research, gather information, interview stakeholders, and evaluate clinical risk scenarios • Monitor emerging risks, trends, and regulatory requirements affecting primary care and value-based care operations • Support continuous improvement of risk management frameworks, controls, and clinical governance processes • Serve as a clinical subject matter resource on clinical risk management, control design, issue mitigation, and regulatory considerations • Report to the Associate VP, Risk Management • Collaborate with leaders across CenterWell Senior Primary Care, Conviva, and MaxHealth

🎯 Requirements

• Bachelor's degree or higher in Nursing, Physician Assistant Studies, or a related clinical discipline • Active and unrestricted clinical license • 5+ years of clinical healthcare experience • Experience collaborating with clinical leadership and interdisciplinary stakeholders • Strong analytical, communication, problem-solving, and risk assessment skills • Ability to evaluate clinical processes, identify risks, and recommend practical solutions • Experience presenting recommendations and findings to leadership audiences • APRN or PA designation preferred • 3+ years of experience in risk management, compliance, audit, healthcare quality, patient safety, clinical operations, or related fields preferred • Experience within value-based care, population health, primary care, Medicare Advantage, or managed care environments preferred • Knowledge of healthcare regulations, internal controls, clinical governance, and risk management frameworks preferred • Familiarity with healthcare operational processes, quality improvement initiatives, and regulatory compliance programs 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 • Life insurance • Internet service requirements/support for home or hybrid home/office employees • Dedicated workspace to protect member PHI / HIPAA information