Risk Manager - Healthcare

The Risk Manager is responsible for overseeing the organization's risk management, incident review, compliance monitoring, and performance improvement activities within a Substance Use Disorder (SUD) and Mental Health (MH) treatment environment. This position supports patient safety, regulatory compliance, accreditation readiness, and operational integrity across detoxification, residential, outpatient, and recovery support services.

The Risk Manager collaborates with clinical leadership, operations, human resources, and compliance teams to identify organizational risks, investigate incidents, develop corrective action plans, and promote a culture of safety, accountability, and continuous improvement.

The position ensures alignment with applicable federal, state, and accreditation standards, including requirements from agencies such as , the FL Department of Children and Families (DCF), FL Agency for Health Care Administration (AHCA),The Joint Commission, , and payer requirements.

Essential Duties and Responsibilities

• Lead organizational risk management activities for SUD and behavioral health programs.
• Investigate incidents, adverse events, grievances, medication errors, patient injuries, elopements, and safety concerns.
• Conduct root cause analyses (RCA) and develop corrective action plans.
• Monitor trends involving patient safety, staff safety, clinical documentation, and regulatory compliance.
• Coordinate incident reporting processes and ensure timely submission to regulatory agencies when required.
• Support accreditation readiness and ongoing compliance with licensing and certification standards.
• Participate in internal audits related to clinical documentation, infection control, medication management, and patient rights.
• Develop and maintain risk management policies, procedures, and training programs.
• Collaborate with clinical and operational leadership to reduce organizational liability and improve patient outcomes.
• Review and analyze data related to incidents, sentinel events, grievances, restraint/seclusion, overdose response, and quality indicators.
• Assist with quality assurance and performance improvement (QAPI/PI) initiatives.
• Maintain confidentiality and compliance with HIPAA and 42 CFR Part 2 requirements.
• Participate in environment-of-care and life-safety rounds.
• Provide education and guidance to staff regarding risk reduction and compliance expectations.
• Prepare reports, dashboards, and presentations for leadership and governing bodies.
• Serve as liaison during regulatory surveys, audits, and accreditation reviews.

Education

• Bachelor's degree in Healthcare Administration, Nursing, Social Work, Behavioral Health, Risk Management, or related field required.
• Master's degree preferred.

Experience

• Minimum of 3–5 years of experience in behavioral health, substance use disorder treatment, healthcare compliance, quality assurance, or risk management.
• Experience in detoxification and residential treatment settings strongly preferred.
• Experience with accreditation standards and regulatory surveys preferred.

Licensure / Certifications

Preferred certifications may include:

• Certified Professional in Healthcare Risk Management (CPHRM)
• Certified Professional in Healthcare Quality (CPHQ)
• Licensed clinician (LCSW, LMHC, LMFT, RN, etc.) preferred but not required

Knowledge, Skills, and Abilities

• Strong understanding of behavioral health and SUD treatment operations.
• Knowledge of ASAM levels of care and behavioral healthcare regulations.
• Familiarity with incident investigation, root cause analysis, and performance improvement methodologies.
• Working knowledge of HIPAA, 42 CFR Part 2, patient rights, and confidentiality requirements.
• Strong analytical, organizational, and documentation skills.
• Ability to manage sensitive and confidential matters professionally.
• Excellent communication and leadership abilities.
• Experience working with electronic health records and incident reporting systems.