Risk Management Director - Healthcare jobs in Los Angeles, CA

JOB OVERVIEW

The Director of Risk Management & Compliance will be responsible for ensuring The Whole Child (TWC) adheres to all contract requirements, applicable laws, regulatory entities, and accrediting bodies while minimizing the risks to the organization. This position will provide supervision and performance management for the staff in the department, as well as serve as the primary contact for accrediting bodies and assigned stakeholders as needed. The Director Risk Management & Compliance will lead all aspects of the accreditation process and program audits. This position is a part of the senior leadership team and reports to the Chief Administrative Officer..

ESSENTIAL FUCTIONS:

• Supervisory responsibilities: Three exempt staff.
• Develop and implement a comprehensive compliance program that includes policies, procedures, and training for staff to ensure compliance with applicable laws, regulations, and industry standards.
• Risk Management/Business Continuity-Disaster Recovery: Provide regulatory analysis and implementation, including oversight, analysis, and communication of regulatory changes to stakeholders.
• Monitors and communicates changes for in program contracts, policies, and other Federal, State and County guidelines/protocols. (Including Medi-Cal Provider Recertification and Council on Accreditation)
• Conducts regular risk assessments to identify potential risks to the organization; develops strategies to mitigate those risks.
• Responsible for internal coordination of program audits and reaccreditation activities.
• Coordinates commercial insurance policy management and distribution of Certificate of Insurance (COI).
• Manages grievance and compliance related investigations and incidents, ensuring proper corrective actions are taken, documented, and tracked.
• Ensures desk level procedures and other key documentation are developed and reviewed.
• Prepare executive summaries, reports, and presentations; develops and conducts training activities for leadership, staff and the Board of Directors as needed.
• Implements the philosophy of quality improvement organizationally by developing and mentoring staff across TWC (i.e., mental health, housing, nutrition, home visitation, administration).
• Build, manage, motivate, and develop teams to monitor and drive consistent quality, efficiency, and enhanced solutions that meet the defined high-quality standards.
• Lead and serve on internal committees and workgroups.

REQUIRED QUALIFICATIONS

• Bachelor's degree in healthcare management, public health, business administration, or related field required.
• At least five years of progressive healthcare compliance and/or audit experience required.
• Knowledge of healthcare and non-profit operations, regulations, and compliance requirements.
• Excellent verbal, written communication and presentation skills required.
• Strong attention to detail and ability to maintain accurate documentation.
• Strong analytical and problem-solving skills.
• Excellent communication skills and the ability to communicate complex issues to a variety of internal and external stakeholders.
• High level of personal integrity and possess the ability to professionally handle confidential matters.
• Two years supervisory experience.
• Valid California driver's license, access to an automobile, and valid state auto insurance.

PREFERED

• Master's degree
• Experience with electronic medical record (EXYM)
• 2 years quality improvement experience

BENEFITS:

• Hybrid Schedule (2 days Remote after 90 days)
• Full benefits package to all positions after 30 days of employment.
• Employer paid standard HMO Health, Dental, and Vision plans.
• 401k plan with 4% employer match.
• PTO that accrues to 15 days annually and increases with seniority.
• 12 Paid Holidays annually.
• Paid Office closure last week of the year.
• $110,000-155,000.00/year starting pay, depending on experience.

CONDITIONS OF EMPLOYMENT:

This description is only intended to identify the duties, responsibilities, and requirements for the position. It is not intended, nor should it be interpreted to describe each and every duty an employee assigned may be required to perform.

PHYSICAL DEMANDS:

• Standing or sitting for extended periods of time along with being able to move and walk, climbing, stooping, kneeling, reaching, pulling, pushing, bending, twisting, and lifting up to 25 pounds.
• Constantly operates a computer using repetitive motions.
• Quickly organizes thoughts and can clearly receive and give information face to face, via technology and in writing.
• Work independently and autonomously, with others, and around others.
• Ability to prioritize work and make decisions.
• Respond effectively to the most sensitive inquiries or complaints.
• High level of concentration and attention to detail for extended periods of time.
• Ability to be flexible, resilient, and creative in approaching complex problems.
• Occasionally must operate a motor vehicle to travel to other sites.

WORKING CONDITIONS:

This is an exempt position, with a hybrid office three (3) days in the office and up to two (2) days remote after 90 days. This can vary based on organizational need. There may be occasional evening or weekend events.