Vice President of Medical Staff

4 weeks ago

Boston MA, United States Blue Cross Blue Shield of Massachusetts, Inc. Full time

Ready to help us transform healthcare? Reporting to the Senior Vice President of Risk and Audit Management, the Vice President of Enterprise Risk Management provides leadership to ensure the optimal design and alignment of all risk management functions in support of Blue Cross and Blue Shield’s (BCBSMA’s) mission, vision and values. Serves as a key executive leader and strategic advisor on risk management across the enterprise. Leads the development and implementation of a risk management vision that delivers strategic thought and partnership across the enterprise. Develops risk management programs that are designed to identify, eliminate or reduce, and insure against potential risks to BCBSMA and its related entities and customers.
Develop BCBSMA’s Enterprise Risk Management strategy and objectives.
Work closely with senior executives to understand and manage enterprise strategic, financial, and operational, risks
Develop, implement, and oversee various risk management vehicles as they evolve from time to time including, but not limited to, the current corporate liability insurance portfolio and a Vermont domiciled captive insurer.
Lead corporate resiliency and preparedness through, among other things, a robust business continuity and disaster readiness program and crisis management response plan.
Lead Third Party/Vendor Security Risk assessment program and related traditional Governance, Risk, and Compliance (“GRC”) program.
Define and develop standards, processes and policy for the evaluation of risk across the enterprise to ensure the organization operates within stated policies.
As a member of the senior management team, participates in company-wide strategic planning, policy formulation, and budgeting.
Present strategy, objectives and other deliverables to the Board of Directors and Senior Management.
Represent the SVP Audit and Risk at internal and external venues including but not limited to with the Division of Insurance
Provide independent and objective risk assessments to executive management, the Board of Directors, BCBS Association and state/federal regulatory agencies as required.
Monitor major and critical risk issues including frequent reporting of outstanding exception items and timeframe for remediation to senior management and board of directors
Create a comprehensive risk-based audit approach that is responsive to BSBC’s internal control, financial and operational risks and reflects a thorough understanding of the company’s business and operations and the changing regulatory environment.
Lead the execution of complex projects, anticipating and providing solutions to complex issues, and allocating and coordinating the necessary resources.
Continue to enhance the company’s risk appetite and limit; structure risk assessment and internal auditing processes relative to best and leading practices.
Establish and maintain effective working relationships with senior management and influences appropriate action across the organization to increase the likelihood of achieving operational objectives and minimizing risks.
Performs management duties including, but not limited to: hiring, training, evaluating, coaching, and developing direct reports. Work with senior stakeholders within the business divisions, strengthening and developing the risk framework and its individual components
Oversee contemporary reporting that informs Senior Leadership
Remain current on business drivers, regulatory and industry changes impacting the business, identify new or emerging risks to which the business is exposed.
Create meaningful partnership with Operations team (IT and Claims) to including consistent participation in staff meetings and other business meetings and forums.
Highly credible risk professional with strong financial acumen.
A seasoned business leader with 15+ years’ experience including experience in Risk Management within the health insurance industry.
Successful leadership of major risk assessments resulting in successful outcomes.
Extensive knowledge and experience with compliance policies, regulations, and procedures.
Bachelor’s degree required (Accounting/Finance/Risk Management preferred).
An employee’s pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.
We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.
You can also join our Talent Community to stay “in the know” on all things Blue.
We provide a flexible hybrid work model in which roles are designated as resident (on site 4-5 days/week), mobile (on site 1-3 days/week), or eworker (on site 0-3 days/month).
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