Business Risk Management Manager

POSITION SUMMARY/RESPONSIBILITIES

Coordinates, develops and administers the Enterprise Risk Management Plan in collaboration with departmental and senior leadership. Leads and monitors remediation plans and objectives designed to minimize and address business risks, ensuring Community First Health Plans, Inc., (Community First) remain compliant with legal, contractual, and governmental regulations. Assists the organization in identifying and monitoring ongoing risk issues, investigates risk concerns, and supports the development of procedures, process improvements efforts, and effective risk governance across the organization

EDUCATION/EXPERIENCE

Bachelor’s degree in Health Care Administration, Business Administration, Finance or related field is required.  Master’s degree in Health Care or Business Management is preferred.  Must have a minimum of five years experience in in contract compliance, preferably in a managed care setting.  Knowledge of Texas Medicaid regulations and Texas Department of Health and Human Services and Department of Insurance regulations required.  Knowledge regarding Medicare and Medicare Advantage preferred