Location
King City CA
Date Posted
1/16/2025
Job Type
Full-Time Regular

Manager of Quality, Regulatory and Risk

Paso Robles Area

Our client is a 25 bed Critical Access not for profit hospital centrally located in California. Minutes to wine country and over 300 wineries!

Experience working in a flat organization with no more than 2 people in between you and the CEO at any time quick decisions and the ability to make an impact without corporate approval. Work with patients in a quaint community from cradle to grave and get to know them as more than just a number!

The Manager of Regulatory, QA, and Risk Management works collaboratively with senior leadership, hospital leaders, physicians and staff to reduce risk and promote quality patient care and safety. This is accomplished through various assessment activities and process improvement actions through the monthly Quality/Patient Safety Committee/Committee of the whole or ad hoc meetings. Manages and coordinates efforts to ensure that quality management programs are developed and managed using a data driven focus and sets priorities for improvements aligned to ongoing strategic imperatives. Ensures compliance with Federal healthcare program requirements and facility’s risk management activities, which include coordinating insurance coverage and risk financing, managing claims against the facility, interfacing with defense legal counsel, administering the risk management program on a management education programs and complying with the Joint Commissions risk management standards, all the objective of controlling and minimizing loss to protect the assets of the facility.

QUALIFICATIONS:
Education:
  • Bachelor Degree in a healthcare related field – Required.
  • RN, JD, or MBA – Preferred.
Work Experience:
  • Minimum three years, recent full-time experience in managing a healthcare facility’s Regulatory, Quality Assurance, and Risk Management – preferred.
  • OR, related experience in a Legal Department performing healthcare compliance work – Considered.
Proven knowledge of healthcare regulatory matters including:
  • Billing and coding, privacy and security, credentialing, and MMHS contracting; managed care experience in Medi-Cal and Medicare highly preferred.
  • Laws relating to Medicare, Medicaid, EMTALA, HIPAA, the Stark Law, the False Claims Act, and the Anti-kickback Statute. Knowledge of Managed care systems of a Knox-Keene licensed health maintenance organization (HMO). Understanding and interpretation of State and Federal regulations.
Licensing Requirements:
  • Certification in Healthcare Compliance, Healthcare Compliance Fellowship, Healthcare Privacy Compliance, Research Compliance, or other relevant areas – Obtained within one year of hire Required.
  • Current State License in a clinical field (five (5) years’ experience in Quality Management can be used in lieu of state license).
  • Certified Professional in Healthcare Quality (CPHQ), or Healthcare Quality and Management Certification (HCQM), or Certificate of Professional Healthcare Quality and Patient Safety (CPQPS) within 2 years of employment Required.

For prompt and confidential consideration, please apply to the link below:

Click here to apply online