Due to the changing economic and regulatory conditions associated with commercial nuclear power generation, effective nuclear safety risk management will be a cornerstone for both the successful continued operation of existing nuclear power plants and the addition of new nuclear-fueled generating capacity. In this paper we describe an integrated framework in which the infusion of risk management into plant programs and processes will cost-effectively ensure this objective is met. This framework has been developed over several years. It includes theoretical modeling of the impact of plant programmatic performance on nuclear safety risk. Analysis of these models permitted identification of attributes that are critical to ensuring effective management of these risks. These attributes were then used to develop a comprehensive risk management effectiveness assessment (RMEA) that identifies the degree to which these attributes are in place. This assessment process has been demonstrated at several pilot plant applications in the United States and Canada. In this paper we discuss this integrated risk management framework and the insights obtained from the theoretical modeling. We also discuss the RMEA and provide illustrative results obtained from its pilot applications. Finally, we provide preliminary results that indicate that nuclear plant safety risk management can be thought of as a complex adaptive system. This classification, if accurate, provides important implications for effective safety risk management.