Job Description
The Director of Risk Management is responsible for leading the risk management function for our Medicare Advantage Plan. This senior role involves strategic oversight of all risk-related activities, ensuring robust risk identification, assessment, and mitigation processes are in place to protect the organization’s assets and ensure compliance with regulatory requirements. The Senior Vice President will work closely with the CEO and other senior leaders to integrate risk management into the overall strategic direction of the company.Key Responsibilities: * Strategic Risk Management:Develop and lead the implementation of an enterprise-wide risk management strategy.Provide strategic guidance to the executive team on risk-related issues and opportunities.Align risk management objectives with the company’s overall goals and initiatives.Leadership and Oversight:Lead the Risk Management department, providing direction and oversight to ensure effective performance.Foster a culture of risk awareness and proactive risk management across the organization.Mentor and develop risk management staff to build a high-performing team.Risk Identification and Assessment:Oversee comprehensive risk assessments to identify potential threats and vulnerabilities.Ensure the development and utilization of advanced risk assessment tools and methodologies.Monitor industry trends and data to anticipate emerging risks.Risk Mitigation and Control:Design and implement robust risk mitigation strategies and controls.Collaborate with senior leaders to integrate risk management practices into all business operations.Oversee the development of contingency plans and business continuity strategies.Regulatory Compliance:Ensure full compliance with federal, state, and local regulations governing Medicare Advantage Plans.Maintain up-to-date knowledge of regulatory changes and their impact on the organization.Liaise with legal and compliance teams to address regulatory challenges.Incident Management:Direct the investigation and resolution of significant incidents and claims.Establish and enforce protocols for incident reporting and management.Analyze incident data to identify root causes and implement preventive measures.Reporting and Documentation:Prepare and present comprehensive risk management reports to the CEO, board of directors, and other stakeholders.Ensure meticulous documentation of risk assessments, mitigation plans, and incident reports.Utilize data analytics to inform decision-making and strategy development.Training and Education:Develop and oversee training programs on risk management policies and procedures for all staff levels.Promote continuous education and awareness of risk management practices.Collaboration and Communication:Act as a key advisor to the CEO and executive team on all risk-related matters.Facilitate effective communication and collaboration between departments to support integrated risk management.Represent company in external risk management forums and industry groups.Qualifications:Master’s degree in Risk Management, Business Administration, Healthcare Management, or a related field.Minimum of 10-15 years of senior leadership experience in risk management, with a strong background in healthcare or insurance.Extensive knowledge of Medicare Advantage Plans and regulatory requirements.Exceptional strategic thinking and analytical skills.Proven leadership abilities and experience managing large teams.Excellent communication, negotiation, and interpersonal skills.Professional certifications such as Certified Risk Manager (CRM) or Certified Professional in Healthcare Risk Management (CPHRM) are highly desirable.Vaco
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