Insurance Risk Manager Jobs in Camarillo, CA (NOW HIRING)

Compensation
Salary Range: $65.66 - $98.96 / hour
The pay range above represents the lowest possible rate for the position and the highest possible rate. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. If you are viewing this posting on a job site, please visit our company page and search for the opportunity to view the pay range: https://careers-mycmh.icims.com/jobs
Responsibilities
Position Overview:
The Manager of Clinical Risk Management and Patient Safety is responsible for the organization's clinical risk management activities throughout the health system. Such activities may include, but are not limited to, managing and analyzing event data, conducting educational programs, providing service recovery, leading patient experience initiatives, managing complaints and grievances in coordination with Patient Experience, and ensuring compliance with risk management-related standards of accrediting and regulatory agencies, with the objective of enhancing patient safety, promoting high-quality care, and minimizing loss. This individual participates in formulating policy and/or organizational changes in coordination with the Director of Patient Safety and Clinical Risk Management.
Qualifications
Required:

• Bachelor's Degree
• Registered Nurse or Clinical experience
• Five (5) years of clinical experience
• Certified Professional in Healthcare Risk Management (CPHRM) certification or must be able obtain within one (1) year of hire
• One (1) year prior Risk Management/Patient Safety experience

Preferred:

• Masters degree

Essential Functions and Responsibilities:

1. Develops, coordinates, and administers facility-wide/clinic-wide systems for risk identification, investigation, and reduction; maintains a network of informational sources and experts; performs risk surveys and inspects patient care areas; reviews facilities to assess loss potential.
2. Participates in committees directed toward promoting patient safety.
3. Maintains risk management statistics and files in compliance with state and federal agencies; promotes maximum confidentiality by limiting access to such information. Ensures that the following information is accurate, available, and secure: includes medical records, patient billing records, policies and procedures, incident reports, medical examiner's reports (if available), and any other data pertinent to a particular claim.
4. Collects, evaluates, and distributes relevant data concerning patient injuries, including aggregate data summaries, monthly trend analyses of incidents, claims profiles, and workers' compensation trends; provides aggregate analysis of risk data; maintains statistical trending of losses and other risk management data.
5. Informs leadership regarding occurrences, issues, findings, and clinical risk management suggestions; provides feedback to leaders at all levels in the effort to eliminate risks; assists clinical chairs and department heads in designing risk management programs within their departments.
6. Recommends appropriate revisions to new or existing policies and procedures to reduce the frequency of future occurrences; recommends ways to minimize risks through system changes; reviews and revises facility policies as appropriate to maintain adherence to current standards and requirements.
7. Organizes and participates in root cause analysis investigation and reporting of adverse events to the appropriate parties.
8. Maintains awareness of legislative and regulatory activities related to health care risk management.
9. Provides in-service training to clinic personnel to enhance their awareness of their role in reducing liability exposures.
10. Designs, implements, and maintains a direct referral system for staff to report unexpected events and potential claims against the facility through input sources such as medical records, business office, patient advocate, nursing, medical staff, and quality improvement, etc.
11. With the Patient Experience Coordinator, reviews patient complaints and grievances that may be the source of potential legal action; discusses and offers solutions, when possible, to resolve any grievances perceived as potential liability claims with the patient and/or family.
12. With the Patient Experience Coordinator, seeks a greater understanding of key drivers contributing to patient satisfaction through analysis of patient survey data and interpretation of patient complaints. Facilitates understanding of the patient experience and the identification and implementation of improvement strategies to achieve patient experience goals.
13. Participates in claims management and occurrence reporting and responds to complaints or claims to obtain information and help facilitate resolution processes.
14. Performs other duties as assigned.

Supervisory Responsibilities:
Provides direct supervision and operational oversight for staff supporting Patient Safety, Clinical Risk Management, and Patient Experience functions, including the Patient Experience Coordinator and the Patient Safety and Clinical Risk Management Coordinator. Responsible for staff scheduling, work prioritization, performance management, staff development, and personnel actions in accordance with Community Memorial Healthcare's policies and procedures. Provides leadership and oversight related to complaint/grievance management, patient experience, event reporting, patient safety initiatives, service recovery, and regulatory compliance activities.
Overview
Nationally Recognized. Community Focused.
Community Memorial Healthcare is proud to earn the 2026 Outstanding Patient Experience Award™ from Healthgrades, placing Community Memorial Hospital - Ventura among the top 15% of hospitals nationwide and one of only 13 hospitals in Southern California recognized for patient experience excellence. Extraordinary patient care begins with extraordinary teams.
View all of our awards and accreditations and learn more about us as you explore career opportunities with a team committed to compassionate, award-winning care.
Community Memorial Health System was established in 2005 when Community Memorial Hospital in Ventura merged with Ojai Valley Community Hospital. It is comprised of these two hospitals along with a network of primary and specialty care health centers serving various communities across west Ventura County. Our health system is a community-owned, not-for-profit organization. As such, we are not backed by a corporate or government entity, nor do we answer to shareholders. We depend on - and answer to - the communities we serve.
Community Memorial Healthcare Benefits
To help heal, comfort, and promote health for the communities we serve, Community Memorial Healthcare takes care of our community of employees so our local community can be cared for. That's why we provide competitive benefits, along with great career choices, training, and leadership development. Our total rewards package provides benefits that support you and your family's health and wellness in all aspects of life. From our top tier insurance plans to our employee assistance program, take advantage of what CMH has to offer so you and your loved ones can have peace of mind now and for years to come. CMH is here for you and your family every step of the way.

• Competitive Pay
• Shift Differentials
• In-House Registry Rates
• Fidelity 403(b) Retirement Plan
• Paid Time Off
• Medical (EPO/PPO), Dental, & Vision Insurance Coverage
• Voluntary Worksite Benefits
• Employee Assistance Program Available 24/7 (EAP)
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF)
• Recognition programs
• Employee service recognition events
• Home, Retail, Travel & Entertainment Discounts
• National Hospital Week and National Nurses Week celebrations

Community Memorial Healthcare is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation. We strive to promote an environment where exceptional people bring diverse perspectives and find belonging, support and connection to their work in our community.
"We are an AA/EEO/Veterans/Disabled Employer"