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Senior Risk Management Specialist in Healthcare

2 months ago

Bismarck, North Dakota, United States CenterWell Full time
Position Overview
The Senior Risk Management Specialist in Healthcare at CenterWell plays a crucial role in identifying and assessing potential risks to mitigate losses effectively. This position involves addressing moderately complex to intricate challenges where a thorough analysis of diverse factors is essential.

Key Responsibilities
  • Develop and enforce compliance policies and procedures while researching compliance matters and suggesting modifications to ensure adherence to regulatory obligations.
  • Evaluate the potential impact of risks and implement effective controls and cost-efficient strategies to reduce organizational vulnerabilities.
  • Oversee the compliance program by estimating risks, driving auditing and monitoring efforts, and providing guidance on compliance matters while remaining informed about relevant laws and regulations.
  • Prepare compliance reports, guidance documents, and data analyses for senior management or regulatory bodies as necessary.
  • Ensure that departmental milestones and objectives are achieved.
  • Contribute to the development and execution of the company's risk and compliance assessment strategies.
  • Proactively identify and resolve compliance challenges, integrating compliance risks with business insights.
  • Lead or participate in cross-functional committees, representing the Risk Management Department in significant decision-making processes.
  • Design and deliver compliance training programs.
  • Assist senior leaders with federal, state, and administrative disclosure requirements.
  • Analyze data to identify instances of suspected fraud, waste, and abuse.
  • Manage external vendors to ensure timely and budget-compliant deliverables.
  • Support additional Risk Management Department initiatives and projects as assigned.

Qualifications
  • Bachelor's Degree in a relevant field.
  • A minimum of five years of experience in healthcare compliance, corporate compliance, healthcare risk management, healthcare policy, legal, or a related area.
  • Strong knowledge of healthcare compliance laws and regulations, particularly in Medicare and Medicaid.
  • Exceptional verbal, interpersonal, and written communication skills.
  • Proven ability to distill complex information into clear, actionable communications.
  • Experience in identifying, developing, and implementing process enhancements.
  • Strong relationship-building skills with key stakeholders across various organizational levels.
  • Excellent project management capabilities.
  • Intermediate proficiency in Microsoft Office applications, particularly Excel and PowerPoint.

Preferred Qualifications
  • Graduate or advanced degree.
  • Previous experience in a healthcare provider organization is highly desirable.
  • Prior experience with Medicare, Medicaid, or government oversight is strongly preferred.
  • Healthcare Compliance Certification or other relevant professional credentials.

Additional Information
This role requires the ability to travel to various clinic locations and necessitates a valid state driver's license along with appropriate insurance coverage.

Compensation
The estimated compensation range for this position is $76,800 - $105,800 annually, based on experience and qualifications. This role is also eligible for a bonus incentive plan based on individual and company performance.

About CenterWell Senior Primary Care
CenterWell Senior Primary Care is dedicated to providing proactive and preventive care to seniors, focusing on personalized experiences that include wellness visits, chronic condition management, and more. We are committed to fostering a supportive environment that prioritizes health and well-being.