Senior Director, Clinical Risk Management

Morgan Consulting Resources, Inc. has been retained to conduct the search for the Sr. Director, Clinical Risk Management for Inland Empire Health Plan. The role is based in Rancho Cucamonga, CA. A hybrid schedule is available allowing for three days in the office and two days working remotely.

About the Organization:

With a mission to heal and inspire the human spirit, Inland Empire Health Plan (IEHP) is one of the top 10 largest Medicaid health plans and the largest not-for-profit Medicare-Medicaid plan in the country. In its 29th year, IEHP supports nearly 1.6 million members who are enrolled in Medicaid and has a growing network of over 8,000 providers and nearly 4,000 Team Members (Employees). Through dynamic partnerships, award-winning service, and a tradition of quality care, IEHP is fully committed to its Mission, Vision, and Values.

IEHP has consistently achieved outstanding employee engagement scores from their 4,000 Team Members and was most recently recognized and awarded the designation of ‘Great Place to Work’ for a third year in a row!

For details regarding IEHP, please visit: iehp.org.

About the Position:

Reporting to the Chief Quality Officer, the Senior Director of Clinical Risk Management provides strategic leadership and oversight for the development and implementation of the health plan’s clinical risk management program and plan. This role is accountable for identifying, assessing, and mitigating risks that could impact organizational performance, regulatory compliance, and member safety. The Senior Director collaborates with executive leadership, operational teams, and regulatory agencies to ensure member safety, adherence to state and federal requirements, accreditation standards, and industry best practices.

Key areas of responsibility include:

• Organizational Leadership & Culture – Driving a culture of member safety and accountability across the organization.
• Strategy & Program Development – Designing and implementing enterprise-wide clinical risk management frameworks and protocols.
• Compliance & Regulatory Oversight – Ensuring compliance with all applicable regulations and accreditation standards.
• Risk Monitoring & Mitigation – Identifying emerging clinical risks and leading proactive intervention strategies.
• External Relations & Reporting – Building strong stakeholder relationships and providing transparent reporting to leadership and governing bodies.

Direct Reports: Quality Management Director, Grievance and Appeals Director

Total Staff Number: 140

Experience Requirements:

• A minimum of ten (10) years of progressive experience in clinical risk management within a health plan or healthcare setting.
• A minimum of three (3) years of proven leadership experience managing enterprise risk programs.

Educational Requirements:

• Bachelor's degree in nursing and/or related field from an accredited institution is required.
• In lieu of the required degree, a minimum of an associate’s degree in nursing and/or related field from an accredited institution plus two (2) years of additional relevant work experience are required for this position. This experience is in addition to the minimum years listed in the Experience Requirements above.
• Preferred: A Master’s degree in nursing or related field from an accredited institution is preferred.

Salary range: A reasonable starting salary expectation is between $232,793.60 and $302,536.00, based upon related/relevant experience and internal equity.

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Meaningful Interest Points About Rancho Cucamonga:

Rancho Cucamonga has all the amenities and qualities that make for a family-friendly city. The public schools in the city are performing slightly above the national average. In fact, the average test score here is 2% higher than the national average and the student-teacher ratio is 23:1. And in 2018, this city was part of the happiest towns to live in the United States. This is a result of its wellbeing, community and environment, and income and employment. The city continues to excel over the years. For example, in 2020, the national civic league named it one of the Ten All-America cities due to its efforts and improvements in healthcare and wellbeing.

The centralized location of the town is one of the best perks, no matter where you are heading out to! From Rancho Cucamonga, you can get to San Diego in less than two hours, Palms Springs in just slightly above an hour, and Los Angeles in only 45 minutes by car. The town isn’t only close to major cities, but you can easily access beaches and mountains from here.