Manager, Audit & Risk Management

Job Description

Job Description

Job Title: Manager, Audit & Risk Management
Department: Compliance
Position type: Full Time
FLSA: Exempt
Reports to: Director, Compliance, Privacy & Risk
Direct reports: Yes

Job Summary
Join a mission‑driven team that values innovation, collaboration, and continuous development. The Manager, Audit & Risk Management supports the Director of Compliance in overseeing organizational compliance, risk, and audit functions. Core responsibilities include coordinating quarterly risk assessments, preparing leadership and Board reports, overseeing internal audits and incident tracking, facilitating vendor management and contract oversight, assisting with policy development and compliance training, and supporting site visit preparation to ensure regulatory adherence and organizational integrity.

Duties/Responsibilities

• Support the quarterly Compliance & Risk Management Committee meeting.
• Collect and analyze data from internal audits, incident reports, and other sources to inform risk identification and prioritization.
• Prepare and present quarterly risk management reports and a final year‑end report to the Board covering completed activities, performance status, and proposed risk activities for the upcoming year.
• Coordinate quarterly risk assessments with stakeholders.
• Assist with completion of the Office of the Medicaid Inspector General (OMIG) annual organizational compliance assessment.
• Develop internal audit and risk management work plans and ensure execution.
• Compile and report audit and risk management findings to supervisors, program staff, funders, and committees as required.
• Stay current with state and federal regulations related to hospitals and patient care safety; review and evaluate policies and procedures; recommend revisions and draft new policies as needed.
• Act as the primary facilitator of the Vendor Management & Oversight program.
• Oversee contracts, leases, service agreements, MOUs, Business Associate Agreements, and other agreements in the contracts management system.
• Ensure vendors receive required annual training and manage dissemination and collection of required attestations.
• Ensure compliance‑related trainings are reviewed and updated annually.
• Coordinate with People Operations to ensure staff complete required training tied to compliance standards, risk management, and audit findings.
• Assist the Director of Compliance with training preparation and presentations as needed.
• Maintain the Compliance & Risk Management Training Workplans.
• Develop and maintain policies and procedures for audits and routine data checks.
• Receive incident reports; disseminate and track to appropriate staff for follow‑up and resolution.
• Prepare quarterly incident reports for the Compliance & Risk Management Committee (locations, types, root causes).
• Review and track incident reports in accordance with Article 28 regulations.
• Provide quarterly summaries to the Executive Leadership Team, Compliance & Risk Management Committee, and the Quality Committee.
• Assist with external audits, including HRSA FQHC operational site visit preparation and follow‑up.
• Coordinate pre‑visit audits and communicate requirements to staff; provide support during monitoring visits.
• Monitor timeliness and follow‑up plans for required responses after findings and plans of correction are identified.
• Provide backup for grant/funder site visit meetings to document areas of improvement.
• Perform other duties as assigned.

Required Skills/Abilities

• Proficiency with Microsoft Office; experience in database management and systems development desired.
• Strong understanding of quality improvement (QI) processes, tools, and techniques; quality measurement and reporting; root cause analysis; preventive risk management strategies; accrediting bodies’ standards; and state and federal regulations.
• Knowledge of risk information management systems (RIMS).
• Ability to function effectively, independently, and efficiently in a stressful, dynamic environment.

Education and Experience

• Bachelor’s degree preferred; master’s preparation and risk management certification highly desirable.
• Minimum 5 years of experience in quality/risk management.
• 3–5 years supervisory/leadership experience.
• Clinical background desirable.

Physical Requirements
Stand, sit, walk, use hands to finger, handle, or feel; reach with hands and arms; talk and hear. Occasionally stoop, bend, and lift or move up to 25 lbs. Specific vision abilities include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus.

Equal Employment Opportunity
Trillium Health promotes Equal Employment Opportunity for all, respecting diverse backgrounds, cultures, ages, experiences, and opinions. Employees must meet department performance standards and participate in compliance audits, process improvement, and quality improvement plans.