Quality Assurance Risk Manager

About the role

The Quality Assurance Risk Manager is responsible for identifying, analyzing, and mitigating potential risks that could impact the organization's financial health, reputation, and operational efficiency. This role involves using analytical skills and tools to forecast and manage risks, ensuring compliance with regulatory requirements.

Responsibilities

• Directly interface with Payers/State Agencies in response to and in resolution of measurement-based care.
• Serve as primary contact for program management.
• Aggregate and analyze data from payer Value Base/Quality Incentive Program, indicators, investigations, audits, corrective action plans, licensing inspection surveys, serious incidents, staffing, etc., to identify systemic concerns, trends and make value added recommendations for focused quality improvement efforts.
• Ensure regulatory compliance with quality system procedures, complaint handling, satisfaction survey, safety, and adverse events reporting.
• Serve as Project lead for assigned activities from the quality and risk management plan; delegate and assign project tasks and cases to team members.
• Coordinate with team supervisor/managers on initial assignment of development and follow up for implementation of improvement processes.
• Conduct risk screening/assessments, investigations, and root cause analysis.
• Support the development and implementation of improvement plans in response to identified risk areas.
• Assist in the development of the annual Quality Assurance Risk Management Plan.
• Facilitate Quality/Risk Management meetings & discussion with members of program management relative to quality improvement initiatives.
• Assist with the completion of safety inspection at least annually of each service location owned, rented, or leased by the provider.
• Assist in the development of technology infrastructure to support the Quality Management Process.
• Attend cross training for quality/risk improvement functions.

Qualifications

• Bachelor's degree in human services and/or equivalent experience and/or training required.
• 1-3 years of experience in quality improvement/Assurance/Risk Management required.
• Minimum one year of supervisory or managerial experience.
• Experience in data collection, analysis and interpretation is required.
• Knowledge of regulations, internal policies, and the various services provided by Merakey.
• Able to work within tight timeframes to provide appropriate responses and feedback to program or payers.
• Capabilities to multi-task and prioritize multiple assignments.

Pay & Schedule

• Salary Range: $70,304 - $75,000 depending on experience.
• This is a Hybrid-Remote position with up to 50% travel required to: Sacramento, CA and surrounding areas or San Diego, CA and surrounding areas.

Benefits

• Comprehensive medical, dental, and vision coverage, plus access to healthcare advocacy support.
• Retirement plan -- both pre-tax and Roth (after-tax) options available for employee contributions.
• DailyPay -- access your pay when you need it!
• On the Goga well-being platform, featuring self-care tools and resources.
• Access Care.com for backup childcare, elder care, and household services.
• Confidential counseling, legal, and financial services through our Employee Assistance Program (EAP).
• Tuition reimbursement and educational partnerships.
• Employee discounts and savings programs on entertainment, travel, and lifestyle.
• Access to Pryor Online Learning for free online personal development classes.