Insurance Risk Manager Jobs in Los Angeles, CA (NOW HIRING)

About Us

At Prenuvo, we are on a mission to flip the paradigm from reactive "sick-care" to proactive health care. Our award-winning whole body scan is fast (under 1 hour), safe (MRI has no ionizing radiation), and non-invasive (no contrast). Our unique integrated stack of optimized hardware, software, and increasingly AI, coupled with the patient-centric experience across our domestic and global clinics, have allowed us to lead the change against "we caught it too late again".

We are looking for a highly specialized Clinical Risk Manager who seamlessly blends sharp clinical risk acumen with deep empathy for patient advocacy.

In this role, you will be the primary strategist and operational lead for managing patient complaints and clinical incidents. You will not just log issues; you will actively risk-manage them—evaluating severity, executing established protocols, and determining exactly when to loop in clinical leadership, legal counsel, or operational teams. Simultaneously, you will serve as a vital bridge for our patients, utilizing advanced de-escalation and advocacy skills to navigate sensitive, complex, or emotionally charged conversations, while coaching our clinicians to do the same.

This role does not provide visa sponsorship. Applicants must be legally authorized to work in the United States at the time of hire and must not require employer sponsorship for a work visa (current or future).

Help reshape the world through proactive healthcare while working with cutting-edge technology and high performing teams with deep expertise - join us to make a difference in people's lives!

What You'll Do

• Risk Triage & Resolution: Own the end-to-end management of patient clinical complaints and tickets. Critically assess each situation to determine the appropriate response path and level of escalation.
• Cross-Functional Routing: Make high-level decisions on when to involve legal counsel, clinical directors, radiology teams, or executive leadership, ensuring appropriate organizational alignment on high-stakes issues.
• Patient Safety Organization (PSO) Engagement: Manage the organization's active engagement with the Patient Safety Organization (PSO), ensuring rigorous adherence to quality privilege principles, systematic documentation within the Patient Safety Evaluation System (PSES), and the consistent protection of privileged safety information.
• Investigation & Mitigation: Conduct comprehensive clinical root-cause analyses and incident investigations to develop and implement proactive risk mitigation strategies.

• Balanced Patient Engagement: Serve as the central point of contact for patient inquiries, fostering a balanced dialogue that prioritizes the patient perspective while maintaining objective clinical standards to drive effective and fair resolutions.
• Clinician Communication & Coaching: Partner with Nurse Practitioners, radiologists, and clinic staff to model and coach on empathetic, transparent communication strategies that facilitate resolution and maintain trust following incidents.
• Patient-Centric Advocacy: Champion the patient perspective across the organization, ensuring clinical quality improvements are informed by patient feedback and consistently result in safer, clearer, and more satisfying patient experiences.

• Legally Privileged Reporting: Document investigation findings, risk assessments, and corrective actions with meticulous accuracy under the direction of legal counsel, maintaining strict confidentiality.
• Clinical Chart Reviews: Perform regular chart audits and reviews of Nurse Practitioner consults to identify potential risk vulnerabilities or systemic process gaps.
• Data-Driven Insights: Analyze complaint and incident data to identify operational trends, presenting actionable reports to management to drive continuous improvement.

What You'll Bring

• Clinical Risk Expertise: Proven, dedicated experience in clinical risk management within a healthcare setting (experience with outpatient imaging or MRI services is highly valued). 5+ years of experience.
• Credentials: Active Registered Nurse (RN) license or Juris Doctor (JD) required.
• Patient-Centric Frameworks: Strong background in patient relations, or healthcare conflict resolution, with verifiable skills in de-escalating high-tension situations.
• Regulatory Knowledge: Solid understanding of clinical risk protocols, medical-legal concepts, and frameworks like the Patient Safety and Quality Improvement Act (including PSWP protections).
• Communication Fluency: Exceptional interpersonal, written, and remote communication skills (video conferencing, Slack, Google Suite, and JIRA).

Nice to Haves

• Credentials:
  • JD and RN Dual qualification as a Juris Doctor and Registered Nurse is a major plus.
  • Willingness to obtain multi-state licensure as Prenuvo expands.

Our Values

First: we are Pioneers

• Transforming healthcare requires divergent thinking, bias for action, disciplined experimentation, and consistent grit and determination to maintain momentum. This journey is as challenging as it is rewarding.

Second: we are Platform-Builders

• We're always building foundations that allow us to achieve tomorrow more than we did today. We never lose sight of what's ahead – in a mindset of ownership and duty to our mission.

Above all: we are Patients

• We could all be the next person who walks through our very doors, seeking clarity or peace of mind. We are proud of our impact on our patients' lives, and we won't stop till everyone can benefit from our work.

What We Offer

• An avenue to make a positive impact on people's lives and their health
• We believe in preventative healthcare for everyone, including our team - Prenuvo provides free, whole-body scans to each team member
• Growth opportunities are at the heart of our people journey, we're doing big things with bright minds - there is no single path to success, it can be shaped along the way
• Building strong relationships is at the core of everything we do - our team gets together each week to connect, share, and socialize
• Recognizing time away to restore is vital to our wellbeing - we have a flexible vacation policy and we will encourage you to use it
• We now offer the Prenuvo's Commuter Benefits Plan to help cover your transit and parking costs. Whether you ride, drive, or park, we've got you covered—making your commute easier and more affordable!
• Prenuvo offers a 401(k) retirement savings plan to eligible employees, allowing team members to make pre-tax contributions toward their retirement. While Prenuvo facilitates access to the plan, the company does not currently offer matching contributions.
• We offer a comprehensive benefits package including health, dental, vision, including Mental Health coverage, to support you and your family
• The base salary for this role ranges from $110,000 to $125,000 USD annually, depending upon experience and geographic location

We are an equal-opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

As part of the hiring process, successful candidates will undergo a background check in compliance to applicable federal, provincial, and state rules.

Please be advised that official communication from our recruitment team will only come from our authorized domain [prenuvo.com]. If you are contacted by a recruiter, please ensure their email address ends with @prenuvo.com. We do not use third-party recruitment services or any other email domains for hiring purposes. If you receive communication that you believe to be fraudulent, please report it immediately to jobs@prenuvo.com.