Quality Assurance- Manager of Regulatory, QA, and Risk FT/Day

Company: Lancesoft INC
Location: King City
Posted on: February 18, 2026

Job Description:

Job Description Job Description The Manager of Regulatory, QA, and Risk Management works collaboratively with senior leadership, MMHS 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. This position exists 1) as a channel of communication to receive and direct compliance issues to appropriate MMHS resources for investigation and resolution, and 2) as an internal resource with which concerned parties may communicate after other formal channels and resources have been exhausted. Will work closely with other management who are responsible for ensuring the organization complies with Joint Commission, Health Insurance Portability and Accountability Act (HIPAA), and applicable accreditation standards. Revised 12.20.2024 PERFORMANCE DIMENSIONS AND TASKS Essential Function 1. On-going assessments of regulatory, quality assurance, and risk management, compliance policies and procedures and assist in updating or developing new policies to enhance this positions’ areas of operations. 2. Carry out a vulnerability analysis on the organization’s Regulatory, QA, and Risk programs and activities, discover areas of potential risk and vulnerability, and create and implement solutions to eliminate the potential risks. 3. Develop and implement quality improvement initiatives. 4. Develop action plans and track progress. 5. Train staff on quality improvement processes. 6. Manage and direct healthcare training and educational programs to advance awareness and education of potential Quality, Compliance risks, vulnerability, and reporting. 7. Supervise training in other laws such as the Physician Payment Sunshine Act, HIPAA, Stark Laws, and related state/federal laws to ensure employees are informed on ethical and legal standards. 8. Tracks, reports and ensures the completion of action items resulting from compliance reviews. Analyzes and investigates serious safety events in support of the patient safety program. 9. Conduct or delegate investigations, and coordinate internal and external corrective measures to be executed. 10. Establishes and maintains a mechanism to track access to regulatory and risk information, within the purview of the organization and as required by law to allow qualified individuals to review or receive a report on such activities. 11. Stay informed of current legislation and enforcement issues affecting the healthcare industry, as well as Regulatory, QA, and Risk Management best practices. 12. Prepare report for management on incidents, investigations, and all significant “breach” Regulatory, QA, and Risk issues. 13. Carry out due diligence on new healthcare businesses/service before they are implemented and design effective Regulatory, QA, and Risk integration plans. 14. Accurately, timely, and with due diligence will assist in the preparation and presentations for Joint Commission and other related surveys reflecting compliance to clinical and non-clinical integration of standards. Identifies deficiencies and assist in remedial resolution of such. 15. Responds to complaints and claims related to professional liability and transmits that information to the insurance carrier of legal counsel. At the request of management, legal counsel, or the adjuster, participates in responding to the complaint or claim to obtain information and facilitate settlement at an early stage. Works in coordination with patient ombudsman or acts as same to resolve complaints before they develop into professional liability claims. 16. Receives incident reports and other information regarding untoward occurrences in the facility, such as quality assurance outline or variations, and collates such information systematically to permit analysis pursuant to risk management policy and procedure. Reviews collated data to identify trends regarding accidents or occurrences, and recommends corrective action to management if appropriate. Prepares reports to management regarding data systems and findings. 17. All other duties as assigned 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: a. Billing and coding, privacy and security, credentialing, and MMHS contracting; managed care experience in Medi-Cal and Medicare highly preferred. b. 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 Language Requirements : Must be fluent in English. Physical Demands: Must be able to sit and stand/walk for long periods of time. Must be able to lift and carry up to 30 pounds. Moderate exposure to hazardous waste and chemicals. Special Demands: Ability to supervise and work cooperatively with others. Must be able to delegate duties and maintain efficient standards of operation. Proficiency in Microsoft Office Suite. Proficiency in quality improvement methodologies. Company Description LanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch. Company Description LanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.

Keywords: Lancesoft INC, Walnut Creek , Quality Assurance- Manager of Regulatory, QA, and Risk FT/Day, Legal , King City, California