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Manager, Quality and Risk jobs in United States
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Nsight Health · 15 hours ago

Manager, Quality and Risk

Nsight Health is seeking a Manager of Quality & Risk responsible for overseeing clinical quality, patient safety, and regulatory risk management across telehealth and care management programs. This role ensures compliance with CMS and organizational standards while identifying and mitigating risks in clinical services.
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H1B Sponsor Likelynote

Responsibilities

Lead quality assurance activities across care management programs and pilots (CCM, PCM, RPM, CoCM, RTM, Heart Failure)
Develop, maintain, and monitor quality metrics, KPIs, and outcome measures
Conduct routine chart audits and documentation reviews to ensure clinical accuracy, completeness, and compliance
Identify trends in quality gaps, adverse events, and near misses; recommend corrective actions
Support continuous quality improvement (CQI) initiatives and performance improvement plans
Identify, assess, and mitigate clinical and operational risks related to patient safety, escalation, and care delivery
Develop and oversee incident reporting, investigation, root cause analysis, and follow-up
Develop and oversee patient complaint management system, investigation, root cause analysis, and follow-up
Ensure timely escalation of high-risk clinical scenarios in alignment with organizational protocols
Collaborate with leadership to implement risk mitigation strategies and monitor effectiveness
Ensure clinical workflows and documentation align with CMS requirements, payer policies, and applicable regulations
Support audit preparedness and response, including internal audits and external reviews
Partner with Compliance and Legal teams on policy development, updates, and staff education
Monitor regulatory changes and assess impact on clinical operations and risk exposure
Develop and deliver education related to quality standards, risk management, and best practices
Support onboarding and ongoing training for clinical staff related to documentation, escalation, and safety
Participate in clinical governance committees and contribute to protocol development and updates
Analyze quality and risk data to identify trends, opportunities, and emerging risks
Prepare quality and risk reports for clinical leadership and executive review
Collaborate with analytics teams to ensure accurate data capture and meaningful reporting

Qualification

Active RN licenseQuality assurance experienceRisk management experienceCMS knowledgeChart auditingQuality improvement methodologiesMaster's degreeTelehealth experienceCertification in QualityCommunication skillsAttention to detail

Required

Active RN license or comparable credentials
Bachelor's degree required; Master's degree in nursing, public health, healthcare administration, or related field preferred
5+ years of clinical experience, including care management or telehealth environments
Demonstrated experience in quality assurance, risk management, or compliance
Strong knowledge of CMS care management programs and documentation requirements
Experience with chart auditing and quality improvement methodologies

Preferred

Experience supporting CCM, CoCM, RPM, PCM, or RTM programs
Familiarity with value-based care and population health models
Experience in telehealth or remote clinical operations
Certification in Quality, Risk Management, or Patient Safety (e.g., CPHQ, CPPS) a plus

Company

Nsight Health

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Nsight is the fastest-growing remote patient monitoring, chronic care management, and behavioral health integration company servicing thousands of healthcare providers nationwide.

H1B Sponsorship

Nsight Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (6)
2024 (4)
2023 (2)
2022 (1)
2020 (11)

Funding

Current Stage
Growth Stage
Total Funding
$0.07M
2024-02-14Seed· $0.07M

Leadership Team

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Michael Ciullo
Founder & CEO
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Tim Clark
Chief Technology Officer
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Company data provided by crunchbase