Director of Risk Management & Quality Assurance

Director of Risk Management & Quality Assurance

We are seeking a strategic and operationally-minded Director of Risk Management & Quality Assurance (RM/QA). This pivotal leadership role is responsible for safeguarding clinical excellence and operational integrity across the organization. You will oversee daily clinical operations and service coordination, ensuring our facility remains a leader in patient safety, regulatory compliance, and continuous quality improvement (CQI).

Responsibilities:

• Clinical Operations & Performance Leadership
  • Manage daily clinical operations, staffing, and patient care workflows to ensure seamless service delivery.
  • Lead the design and execution of performance improvement projects aimed at achieving the "Triple Aim": better care, better outcomes, and lower costs.
  • Drive data-driven changes, including team-based care and Patient-Centered Medical Home (PCMH) initiatives, in collaboration with the Chief Medical Officer.
• Risk Management & Compliance
  • Act as the primary point of contact for HRSA, NYSDOH, and CMS; facilitate inspections and manage all Plans of Corrective Action (CAP).
  • Ensure 100% compliance with the 19 BPHC program requirements and oversee the annual FTCA application submission.
  • Manage the end-to-end incident reporting process, ensuring timely notification to state agencies and mandated reporting for sensitive cases.
• Data Analytics & Quality Assurance
  • Leverage EMR (eCW) and reporting tools (COGNOS) to conduct audits and generate actionable quality data.
  • Chair the RM/QA Committee and represent clinical quality data to the Board of Directors and Key Management.
  • Serve as the primary liaison for IPA and ACO contracts, overseeing quality measurement activities and patient satisfaction analytics.
• Safety & Environment of Care
  • Standardize protocols and policies to ensure a consistent culture of safety across all departments (Medical, Dental, and Operations).
  • Oversee emergency preparedness (CMS rules), equipment maintenance, and the overall security/supply chain of the health center.
  • Protect patient rights and lead the resolution of grievances and recommendations.
• Collaborative Human Resources Support
  • Partner with HR to oversee regulatory training programs, staff recruitment, and succession planning.
  • Coordinate with the Compliance Administrator to ensure rigorous maintenance of personnel records, licenses, and certifications.
  • Manage Code Rule 59 and 60 applications and annual reporting in partnership with the HR Director.

Benefits:

• Retirement: 403(b) with matching
• Insurance: Medical, prescription, dental, life, AD&D, malpractice (occurrence-based)
• Time Off: Generous PTO (vacation, sick, holiday, CME)
• Financial Benefits: CME reimbursement, NHSC loan forgiveness, FSAs, pre-tax commuting contributions
• Eligible to receive $2K by the end of the 1st year and 2K annually moving forward

Job Requirements:

• Bachelor's or Master's degree in Nursing, Healthcare Administration, or a related field.
• Minimum of five years of progressive leadership experience in healthcare operations, risk management, or quality assurance.
• Direct experience working within an FQHC or a comparable community-based healthcare organization.
• Comprehensive knowledge of HRSA, NYSDOH, and CMS regulatory requirements.
• Proficiency in Medicare, Medicaid, and third-party billing requirements.
• Current Basic Life Support (BLS) certification.
• Demonstrated ability to lead multi-disciplinary teams and manage complex clinical workflows.
• Experience utilizing EMR systems for data management and quality reporting.
• Exceptional communication skills for reporting to executive leadership and the Board of Directors.
• Familiarity with serving individuals with intellectual and developmental disabilities is highly desirable.

Salary: The posted range is not a guarantee. The actual salary will be based on qualifications, experience, and education and could fall outside of this range. Contact us for more information.

If you're excited about the potential of this role, we'd love to hear from you!