POSITION SUMMARY: The Chief Risk Officer (CRO) is a key member of the Executive Leadership Team (ELT) at RMHCS, responsible for overseeing all aspects of the organization's risk management framework. The CRO will ensure the implementation of robust risk mitigation strategies, regulatory compliance, and continuous improvement processes in a highly regulated healthcare environment. This individual will work collaboratively across departments to assess and address organizational risks, develop contingency plans, and drive initiatives aimed at maintaining RMHCS’s operational efficiency and strategic growth. The CRO will also provide leadership and support to the VP of External Relations, VP of Quality and Compliance, and IT Director, and ensure that all risk management initiatives align with the organization's goals, regulatory requirements, and program regulations.
MISSION: Improving lives, Optimizing wellness, Promoting independence
Competencies
- Effective Supervision
- Balanced Decision Making
- Strategic Focus
- Manages Conflict
- Effective Communication
- Facilitates Change
- Problem Solving
- Quality Focus
- Personal Credibility
- Decisiveness
Responsibilities And Duties
ESSENTIAL JOB FUNCTIONS:
- Development of Risk Management Strategy:
- Lead the development, implementation, and maintenance of the organization's comprehensive risk management strategy and framework, ensuring alignment with RMHCS’s mission and goals.
- Continuously assess and enhance the organization’s risk-related internal controls, operations, and policies.
- Risk Identification and Assessment:
- Identify, assess, and prioritize risks to the organization, ensuring that mitigation strategies are in place for both short-term and long-term risks.
- Work closely with leadership and departments to evaluate operational efficiency and identify opportunities for improvement with a risk mindset.
- Develop contingency and business continuity plans, preparing RMHCS for potential disasters and unforeseen events.
- Regulatory Compliance and Oversight:
- Ensure RMHCS’s compliance with all applicable program regulations, HIPAA standards, and other state and federal regulations.
- Oversee regulatory audits, assessments, and reviews to ensure continuous compliance with internal and external standards.
- Provide expert guidance on risk-related regulatory changes and ensure timely implementation of necessary adjustments.
- Data Analysis and Metrics Reporting:
- Develop and implement data analysis processes to measure risk-related performance across the organization.
- Report on risk metrics, outcomes, and trends to senior leadership, identifying areas of concern and making recommendations for corrective actions.
- Vendor and Contractual Oversight:
- Oversee the risk management aspects of vendor relationships and contracts, ensuring compliance with legal, regulatory, and operational standards.
- Assess risks associated with external partnerships and assist in the development of mitigation strategies.
- Quality and Process Improvement:
- Support the development and continuous enhancement of the organization’s quality improvement strategies and process optimization efforts.
- Ensure the alignment of quality improvement initiatives with risk management strategies, ensuring the effective implementation of utilization management principles.
- Leadership Development and Support:
- Provide mentorship, coaching, and guidance to the VP of External Relations, VP of Quality and Compliance, and Information Technology Director to foster a culture of risk awareness, compliance, and continuous improvement across departments.
- Work closely with the ELT to build and sustain a strong risk, quality, and compliance culture throughout the organization.
- External Relations and Stakeholder Management:
- Maintain highly effective relationships with CMS, HCPF, contracted facilities, and providers to ensure alignment with organizational goals, regulatory requirements, and risk management strategies.
- Collaborate with the VP of External Relations to develop a formal legislative approach and lobbying efforts that align with RMHCS’s priorities and objectives.
- Strengthen RMHCS’s reputation and market awareness, proactively managing and mitigating potential risks to the organization's public image.
- Support for Quality Performance Plans:
- Collaborate with the VP of Quality and Compliance to enhance RMHCS’s Quality Performance Improvement Plans, driving improvements from good to great across all areas of operation.
- Provide input on policies, procedures, and processes, helping to communicate the “why” behind changes and fostering a culture of continuous improvement.
Organizational (core Rating Factors)
- Demonstrate support for the Company’s Mission, Vision and Core Values.
- Provide Exceptional Customer Service.
- Ensure discretion with confidential information in accordance with HIPAA guidelines.
- Support a collaborative work environment including courteous, helpful and professional behavior.
- Embrace Organizational Excellence through practicing individual time management, efficiency and effectiveness and participating in continuous improvement efforts.
- Adhere to and support all Company policies and procedures.
- Support and practice safe work habits in accordance with policies and procedures.
- Bring ideas, problems and concerns forward and participate in resolution and implementation.
- Participate in and complete regulatory compliance training within the prescribed deadlines.
- Attend required meetings.
- Maintain skills and knowledge required including written and verbal communication, best practices for industry standards, and computer competency.
Supervisory (job Specific Tasks)
- Exercise job-related judgment and knowledge.
- Organize and prioritize while working with strict deadlines.
- Responsible for the overall supervision of three direct reports including orientation, counseling, training, scheduling, disciplinary actions (with HR assistance).
- Provide guidance and regular coaching to employees.
- Assign tasks fairly and appropriately to job responsibilities.
- Required to maintain detailed supervisory notes documenting counseling and coaching interactions.
- Must address disciplinary issues in a timely manner applying Company policy.
- Ensure that performance evaluations are conducted thoroughly and in a timely manner.
- Communicate goals and expectations clearly and effectively with direct reports.
- Bachelor’s degree in Risk Management, Healthcare Administration, Business Administration, Finance or a closely related field required.
- Master’s degree in Risk Management, Healthcare Administration, Business Administration, Finance or a closely related field preferred.
- Minimum of 20 years of progressive experience in risk management, with increasing responsibilities in risk-related functions.
- Experience in healthcare, specifically within the PACE program or similar healthcare environments, with a deep understanding of PACE regulations and operations preferred.
- Proven track record in risk management, policy administration, regulatory compliance, fraud prevention, disaster recovery, business continuity, internal auditing, and strategy development.
- Strong understanding of HIPAA regulations and IT risk management principles.
- Experience with organizational quality management and process improvement methodologies, including Lean or Six Sigma.
- Demonstrated success in data analysis, metric development, and reporting.
- Exceptional leadership, communication, and interpersonal skills, with the ability to build and maintain effective relationships with internal and external stakeholders.
- Highly collaborative, with the ability to work across multiple departments and influence decision-making.
- Strong analytical and problem-solving skills, with the ability to identify risks and recommend practical solutions.
- Ability to thrive in a dynamic and highly regulated healthcare environment, managing competing priorities and deadlines.
We strive to provide our employees with a comprehensive and affordable benefits package including Medical and Prescription Drug, One Medical, Dental, Vision Care, Wellness Program, Telemedicine Program, Flexible Spending Accounts, Health Savings Account, Company Paid Basic Life and Accidental Death & Dismemberment, Company Paid Long-Term Disability, Voluntary Life Insurance, Voluntary Short-Term Disability, Accidental Injury Insurance, Critical Illness, Hospital Indemnity, 403(b) Savings Plan, Legal Shield and IDShield, Employee Assistance Program (EAP), Paid Time-Off plan. Such benefits are based on applicable state law and factors such as pay classification (full-time, part-time, or PRN/casual), job grade and length of service.
