Integrated Care Risk Manager

Ashland, KY
Full Time
Mid Level

Function:

The Integrated Healthcare Risk Manager is responsible for overseeing and coordinating risk management activities across the organization, which includes behavioral health, primary care, substance use disorder services, foster care, and residential services. This role ensures compliance with state and federal regulations, CARF accreditation standards, and payer requirements, while promoting a culture of safety, accountability, and continuous improvement. The Risk Manager supports all service lines, including BHSO (Behavioral Health Service Organization), AODE (Alcohol and Other Drug Entity), PCP (Private Child Placing), PCC (Private Child Caring), FQHC (Federally Qualified Health Center), and CCBHC (Certified Community Behavioral Health Clinic) operations.

Organizational duties & responsibilities:

  1. The primary responsibility of all staff is to ensure the safety and well-being of all Ramey-Estep/Re-group (RE) clients.
  2. Supports the mission, vision, and values of RE.  Facilitates and adheres to the agency’s code of ethics, policies, and procedures.
  3. Supports all functions that attain and maintain accreditation and compliance with regulatory agencies.
  4. Supports and facilitates positive interaction with clients and staff by exhibiting both in-office and in-public when carrying out job duties:  individual maturity, respect for others, a team-centered approach, maintenance of confidential information, and awareness and sensitivity to cultural and other differences in clients and staff.
  5. Exhibits effective communication skills, including proper use of agency communication systems.
  6. Participates in appropriate professional development programs to attain and maintain competency.
  7. Effectively manages financial and physical resources to achieve the mission of RE.
  8. Reports incidents of abuse or potential abuse involving clients to the appropriate authorities and RE.

Essential Duties and Responsibilities:

  1. Proactively identify clinical, operational, and environmental risks across service lines.
  2. Conduct regular risk assessments, audits, and investigations into safety events, near misses, and client/staff incidents.
  3. Monitor risk trends and develop mitigation strategies, action plans, and preventive measures.
  4. Manage the organization’s incident reporting system and ensure timely documentation, analysis, and resolution of risk-related events.
  5. Collaborate with clinical and executive leadership to investigate adverse events and develop improvement plans.
  6. Ensure organizational compliance with state and federal regulations (e.g., Kentucky Department for Behavioral Health, Medicaid, HRSA, SAMHSA, etc.).
  7. Maintain knowledge of applicable licensing, credentialing, and certification requirements, including for BHSO, AODE, PCC, PCP, FQHC, and CCBHC.
  8. Oversee adherence to CARF standards, participate in CARF survey preparation, and lead post-survey corrective action planning.
  9. Assist leadership in the development, update, and implementation of policies and procedures related to risk management, patient safety, incident reporting, and emergency preparedness.
  10. Conduct training for staff on risk prevention, compliance standards, ethical conduct, documentation standards, and reporting protocols.
  11. Work closely with quality improvement, compliance, leadership, and operations teams to align risk strategies with quality goals.
  12. Participate in the organization’s Quality Assurance and Performance Improvement (QAPI) committee and other relevant workgroups.
  13. Monitor professional and general liability coverage and work with external counsel or insurers to manage claims and settlements.
  14. Maintain documentation and reporting related to potential or active claims.
  15. Other duties as assigned.

Working conditions/environment:

  1. Shift is generally Monday – Friday, but hours will vary.
  2. Holidays, weekends, and extra hours may be required, not to exceed part-time employment hours.
  3. Office environment with occasional travel to service sites for training, audits, and investigations.
  4. Participation in emergency response planning and periodic after-hours consultation may be required.
  5. Maintains a positive, professional attitude contributing to a supportive work environment.
  6. The job is primarily completed on the computer.

minimum job requirements:

Education:

Bachelor's degree in healthcare administration, public health, behavioral health, nursing, social work, or a related field required. Master’s degree preferred.

Experience:

Minimum of 3–5 years of risk management or compliance experience in an integrated healthcare or behavioral health setting.
Strong knowledge of Kentucky regulations for BHSO, AODE, PCC, PCP, FQHC, and CCBHC operations.
Familiarity with CARF standards and accreditation processes.
Experience with incident reporting systems and root cause analysis.
Certification in risk management, compliance, or healthcare quality (e.g., CPHRM, CHC, CPHQ) preferred.

Specific Skills and

requirements:

Must be at least 21 years of age.
Strong leadership and organizational skills.
Excellent communication, problem-solving, and training facilitation skills.
Valid Driver’s License and insurability.
Technical requirements include proficiency with Microsoft Word, Excel, PowerPoint, and any other applications used by the organization or regulatory agencies.
Demonstrated ability to manage confidential information with discretion.
Ability to understand and relate to the needs of clients from diverse backgrounds.
Ability to read, write and converse in English.
Successful completion of a pre-employment drug screen.
Successful completion of a background screening.
Successful completion of a TB skin test or proof of a negative chest x-ray or other documentation.

Specialized Licenses or training:

Successful completion of Excellent Foundations.
Maintains 20 hours of Annual Training through Relias or other appropriate sources.
Maintains at least minimum training for licensure.
Attends all assigned training specific to job assignment.

Physical Requirements:

The physical requirements described here are representative of those that must be met by an employee to perform the essential functions of this job successfully.  Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
While performing the duties of this job, the employee is regularly required to stand, walk, talk, hear, and smell.  The employee frequently is required to sit; use hands to finger, handle, or feel; reach with hands and arms; and stoop, kneel, crouch, and climb stairs.  The employee is occasionally required to climb, balance or run.  Specific vision abilities required by this job include close vision, distance vision, and peripheral vision. 

Supervisory REquirements:

N/A
  • Annual salary starts at $55,000
  • Full, competitive benefits package included
    • Insurance (Medical, Dental, Vision, Life)
    • 401(k) program, immediate vesting & generous matching
    • Short & Long-term disability insurance
    • Generous paid leave and holiday program
    • Professional development assistance offered
    • Public Loan Forgiveness eligible
    • Flexible work schedule
    • AND MORE!
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