Risk Manager

Spectrum Health & Human Services•Orchard Park, NY

2d•$51,784 - $66,025•Onsite

About The Position

Spectrum Health & Human Services respectfully partners with adults, children, and families as they recover from behavioral, emotional, mental health, and/or substance-related disorders, offering individualized opportunities for hope, empowerment, and support. The Risk Manager leads and coordinates the agency-wide risk management process, partnering with leadership to identify, assess, and mitigate organizational risks. The position supports compliance investigations, corrective actions, and ongoing monitoring in collaboration with the Compliance Officer and Compliance Manager. It also contributes to risk-based monitoring, employee training, policy development, cross-departmental coordination, and efforts to foster a proactive, non-retaliatory culture of risk identification and reporting.

Requirements

Bachelor’s degree in healthcare administration, business, finance, risk management, compliance, social work, or a related field.
Minimum of five years of progressively responsible experience in healthcare or human services involving risk management, investigations, auditing, or related functions is preferred.
Valid driver’s license with an acceptable driving record.
Strong knowledge of healthcare laws and regulations.
Ability to work effectively with people from a variety of cultural and ethnic backgrounds.
Skilled in using computers and related software applications.
Strategic thinking, sound decision-making, and the ability to analyze and solve problems.
Ability to maintain confidential information.
Strong facilitation and collaboration skills to build cross-functional partnerships and drive results.
Strong written, verbal, analytical, and research skills, including the ability to synthesize information and inform outcomes.

Nice To Haves

Experience conducting organizational risk assessments, investigations, and corrective-action or risk-mitigation activities is strongly preferred.
Master’s degree or other advanced degree preferred.
Five years of progressively responsible healthcare or human services experience involving risk management, investigations, auditing, or related functions is preferred.

Responsibilities

Administer and maintain a consistent agency-wide risk assessment process, including identifying, evaluating, prioritizing, documenting, and monitoring organizational risks.
Partner with department leaders on routine and event-driven risk assessments; develop controls and mitigation strategies; and track actions through completion.
Maintain organizational risk assessments and mitigation plans, including completion targets, control measures, and residual-risk documentation.
Assess operational, regulatory, financial, workforce, technology, and reputational risks; review existing controls and identify future risk management needs.
Monitor internal and external developments, regulatory guidance, audit activity, funding-source requirements, payer expectations, contracts, and organizational experience for current and emerging risks.
Work with departments to identify documentation, billing, medical necessity, credentialing, service delivery, and regulatory risks, and recommend monitoring or corrective action.
Monitor OMIG and OIG work plans, guidance, notices, alerts, and enforcement activity; assess organizational impact and coordinate responses with Compliance and operational leadership.
Identify compliance vulnerabilities and work with responsible departments to develop corrective-action and mitigation plans.
Partner with contract owners and departments to assess risks associated with vendors, contractors, subcontractors, business associates, consultants, and external partners.
Develop key risk indicators and metrics, and provide findings to the Compliance Officer and senior leadership to inform work plans, monitoring priorities, training, policies, and resource allocation.
Receive, document, and triage complaints, reported concerns, hotline matters, and potential compliance issues assigned by or coordinated with the Compliance Officer; conduct or support investigations and prepare objective summaries, analyses, findings, and recommendations.
Conduct fact-finding activities, including interviews, document and data review, chronology development, and collection and preservation of relevant information, while maintaining confidentiality and appropriate records.
Maintain a centralized tracking mechanism for complaints, compliance concerns, corrective actions, and closure determinations under the formal authority of the Compliance Officer.
Conduct or coordinate risk-based reviews and monitoring against applicable federal, state, local, payer, contractual, grant, and other funding-source requirements.
Recommend monitoring priorities using risk assessments, complaint and investigation trends, external findings, prior audits, regulatory changes, and leadership input; partner with departments on controls and monitoring plans.
Coordinate with Human Resources, Training, Compliance, Quality Improvement, and operational leadership to identify risk-related training needs and contribute content to orientation, supervisor development, annual compliance education, and department-specific training.
Facilitate cross-departmental communication and promote a culture where employees and leaders proactively identify, report, discuss, and address risk without fear of retaliation.
Support the Compliance Manager in administering and monitoring OIG exclusion and sanction screening.
Recommend policy revisions related to federal or state compliance requirements based on risk assessments, investigations, complaints, regulatory changes, and corrective-action reviews.
Partner with program leadership to include business continuity, emergency preparedness, cybersecurity, workforce disruption, and service-continuity risks in assessments.
Follow and model the standards of a high-performing team member.