Senior Manager of Clinical Risk and Compliance

Fair Haven Community Health Care•New Haven, CT

About The Position

Fair Haven Community Health Care (FHCHC) is seeking a Senior Manager of Clinical Risk and Compliance to manage the day-to-day operations of the organization’s clinical risk mitigation and HIPAA privacy programs. This role ensures continuous compliance with Federal Tort Claims Act (FTCA) deeming standards and HRSA Health Center Program requirements. The position serves as the primary lead for daily privacy workflows and incident investigations, working in close coordination with the Privacy Officer.

Requirements

Graduate degree in nursing, public health, or other relevant field required
At least 5 years of professional experience required
Excellent communication (verbal, written, and presentation) skills
Strong project management skills managing complex, multifaceted projects resulting in measurable successes and program growth
Quality improvement, systems change, and policy development skills
Strong analytic skills; experience mining an EHR for required data
Demonstrated knowledge of federal and state regulations

Nice To Haves

Certification in Healthcare Privacy Compliance (CHPC) or Certified in Healthcare Compliance (CHC) preferred.

Responsibilities

Leads the technical data collection and administrative assembly of the Risk Management and Credentialing and Privileging (C&P) sections of the annual FTCA deeming and redeeming applications to ensure all submissions meet HRSA/BPHC standards.
Executes comprehensive annual clinical risk assessments across all departments to identify vulnerabilities and satisfy federal requirements.
Facilitates investigations into clinical incidents and "near misses," leading Root Cause Analysis (RCA) in collaboration with clinical leadership.
Oversees the formal grievance process, ensuring systemic issues are identified and addressed to mitigate organizational liability.
Synthesizes clinical risk data into high-level reports for the CCO, CMO, and the Board of Directors to guide strategic decision-making.
Coordinate the Risk Management Committee, including agenda preparation and minute-taking.
Monitors the overall compliance of the Credentialing & Privileging system, ensuring that processes for Licensed Independent Practitioners (LIPs), Other Licensed or Certified Practitioners (OLCPs), and Other Clinical Staff (OCSs) meet HRSA standards.
Conducts periodic audits of credentialing files and tracking systems to ensure primary source verification and fitness for duty are documented correctly by the Credentialing Manager.
Monitors the administrative framework for Focused Professional Practice Evaluations (FPPE) and Ongoing Professional Practice Evaluations (OPPE) to ensure timely completion.
Leads the hands-on investigation of potential HIPAA violations, unauthorized disclosures, or privacy complaints.
Performs formal privacy risk assessments for each reported incident and presents findings to the Privacy Officer for final determination.
Executes privacy mitigation plans and maintains the documentation required for HIPAA compliance and state/federal reporting.
Designs and implements the annual clinical risk and privacy training plan for all staff to satisfy mandatory FTCA and HIPAA requirements.
Conducts educational sessions for clinical and administrative staff on risk reduction, privacy safeguards, and regulatory compliance.
Leads the drafting and periodic revision of clinical risk and privacy policies to reflect current regulatory changes and internal audit outcomes.