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CLINICAL RISK & COMPLIANCE MANAGER

Kheir Clinic
Los Angeles, CA Full Time
POSTED ON 1/14/2025
AVAILABLE BEFORE 4/10/2025

Clinical Risk & Compliance Manager

The Clinical Risk & Compliance Manager oversees the organization's risk management and

patient safety programs, providing essential guidance to clinical staff. Key responsibilities

include developing systems to detect, monitor, and manage patient adverse events,

malpractice claims, and incident reports, all aimed at enhancing health outcomes and patient

safety while minimizing errors in healthcare processes. This role supports the Comprehensive

Compliance Program by implementing Compliance and Regulatory Plans and facilitating

responses to contracted audits.

This position combines strategic thinking with meticulous attention to detail, encompassing

policy implementation, effective training programs, internal monitoring, and directing

investigations. The manager also facilitates risk management committees to ensure compliance

with laws, regulations, and internal policies. Reporting to the Director of Human Resources &

Compliance, they will collaborate cross-functionally to elevate compliance awareness and

strengthen the organization's compliance culture. Overall, this is a key, high-visibility role

critical to fostering a robust compliance program.

QUALIFICATIONS

  • Ability to apply principles of logical or scientific thinking to a wide range of intellectual

and practical problems.

  • Knowledge of auditing and monitoring procedures.
  • Working knowledge of California patient and individual privacy laws and regulations.
  • Clear, concise and persuasive writing and presentation skills using information
  • systems, databases, Excel, PowerPoint and Microsoft Word.

  • Enjoy working as a member of a cohesive team and is effective at doing so.
  • Ability to make meaningful observations and write comprehensive and accurate
  • reports.

  • Self-starter who is comfortable making key decisions and holding others accountable
  • for compliance standards.

  • Ability to translate / provide cogent advice to senior management regarding the impact
  • of emerging industry trends in compliance enforcement, legislation and regulations on

    affiliate business strategies.

  • Must understand and lead by communicating vision, exhibiting decisiveness,
  • sponsoring change and supporting the larger organization success.

  • Must exhibit a credible leadership presence, with the ability to respond to questions
  • with logic, clarity, calmness and authority, leading to desired support of / actions by

    others.

  • Proven leadership skills in a healthcare compliance environment.
  • Ability to work well with others to ensure the highest ethical standards.
  • RESPONSIBILITIES

    The essential functions listed are typical examples of work performed by positions in this job

    classification. They are not designed to contain or be interpreted as a comprehensive inventory

    of all duties, tasks and responsibilities. Employees may perform other duties as assigned.

  • Proactively evaluate areas of organizational risk based on internal assessment and
  • external benchmarking and implement strategies and policies that promote patient and

    staff safety.

  • Promote the occurrence reporting process including trending and reporting of results,
  • identification of problem-prone areas, and facilitation of prevention initiatives.

  • Lead the review of serious occurrences requiring root-cause analysis or failure mode
  • and effects analysis. Disseminate lessons learned and process improvement plans.

  • Analyze all statistical reports and advisories that identify risk management and patient
  • safety patterns and trends for leadership.

  • Prepare & revise the Compliance Plan as dictated by changes in statutes, rules,
  • regulations and requirements of Federal, state and health plans. Take responsibility for

    all reporting requirements contained within the plan.

  • Prepare annual work plans addressing the priority compliance risk exposures for
  • review by the Compliance Committee.

  • Organize and lead efforts regarding all compliance audits.
  • Develop, coordinate, and participate in educational and training programs that focus on
  • the elements of the Compliance Program.

  • Ensure that all appropriate employees and managers are knowledgeable of, and comply
  • with, pertinent Federal, State and payer health care program requirements.

  • Develop and implement methods and programs that encourage managers and
  • employees to report possible noncompliance.

  • Coordinate with other department heads to ensure seamless implementation of policies
  • and procedures between Compliance and Operations.

  • Provide quarterly updates to the leadership team regarding progress toward the
  • Compliance plan and results of related audits and monitoring functions.

  • Identify high risk areas to reduce agency's vulnerability to fraud, waste and abuse.
  • Support Human Resources in investigation and tracking of employee performance and
  • conduct allegations and incidents.

  • Exercise day to day responsibility in the oversight of HIPAA training and compliance;
  • act as HIPAA Privacy Officer.

    EDUCATION / LICENSES / REGISTRATIONS

  • Minimum Bachelor's degree required with relevant experience in healthcare compliance
  • program development.

  • Seven (7) years' experience which must include a minimum of two (2) years' experience
  • in healthcare compliance with demonstrated leadership, and a minimum of two (2)

    years' experience of supervisory capacity with participation in cross-departmental

    committees. Exposure to managed care with FQHC knowledge highly desirable.

  • Familiarity with operational, financial, quality improvement, and human resources
  • procedures and regulations is required.

  • Valid driver's license & auto insurance.
  • Excellent interpersonal skills; ability to develop important relationships with key
  • stakeholders.

  • Good conflict management and negotiation skills.
  • Ability to analyze complex issues to develop relevant and realistic plans, programs and
  • recommendations.

    Kheir Clinic provides equal employment opportunities (EEO) to all employees and applicants for

    employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In

    addition to federal law requirements, Kheir Clinic complies with applicable state and local laws governing

    nondiscrimination in employment in every location in which the company has facilities. This policy

    applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion,

    termination, layoff, recall, transfer, leaves of absence, compensation and training.

    Kheir Clinic will consider for employment all qualified Applicants, in a manner consistent with the

    requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative

    for Hiring Ordinance.

    Please note that this job description is subject to change to meet the needs of Kheir Clinic.

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