St. Tammany Health System logo
St. Tammany Health System

World-class healthcare. Close to home.

Quality & Risk Manager

RiskRiskFull TimeRemoteSeniorTeam 1,001-5,000H1B No SponsorCompany SiteLinkedIn

Location

Louisiana

Posted

22 hours ago

Salary

0

Seniority

Senior

Bachelor Degree5 yrs expEnglish

Job Description

Quality & Risk Manager

St. Tammany Health System

• Provides strategic and operational leadership for clinical documentation programs • Supports quality reporting, severity of illness and risk of mortality (SOI/ROM), value-based reimbursement, and risk-adjusted outcomes • Oversees CDI/CDE staff and conducts documentation audits • Ensures compliance with regulatory and risk‑based reimbursement requirements • Identifies documentation gaps and trends and drives continuous improvement initiatives • Promotes operational efficiency and documentation excellence across the organization • Collaborates closely with physicians, coding teams, and CDI/CDE advisors to enhance documentation quality • Develops and delivers targeted education on documentation best practices

Job Requirements

  • Graduate of an accredited School of Nursing
  • 5 years of clinical experience in an acute or ambulatory care setting
  • 3-5 years of leading/managing a clinical documentation team
  • Current State Registered Nurse License
  • Excellent written, verbal, and interpersonal communication skills
  • Demonstrated leadership and team-building abilities
  • Strong analytical and critical-thinking skills
  • In-depth knowledge of clinical documentation requirements, ICD‑10‑CM coding guidelines, and risk‑adjustment methodologies
  • Ability to maintain current knowledge of regulatory requirements, industry trends, and emerging risk‑adjustment and documentation programs
  • Experience managing departmental operations
  • Strong organizational, planning, and time‑management skills
  • Proficiency with Microsoft Office applications and clinical documentation and coding tools

Benefits

  • Competitive salary
  • Professional development opportunities
  • Flexible working arrangements

Related Categories

Related Job Pages

More Risk Jobs

Zayo Group logo

Senior Manager, Controls & Governance

Zayo Group

Zayo provides mission-critical bandwidth to the world’s most impactful companies, fueling the innovations that are transforming our society. Zayo’s 141,000-mile network in North America and Europe includes extensive metro connectivity to thousands of buildings and data centers. Zayo’s communications infrastructure solutions include dark fiber, private data networks, wavelengths, Ethernet, and dedicated Internet access. Zayo serves wireless and wireline carriers, media, tech, content, finance, healthcare and other large enterprises.

Risk1 day ago
Full TimeRemoteTeam 1,001-5,000

Role Description Zayo is looking for a rare operator — a leader who can bring structure to complexity, discipline to scale, and visibility to large, fast-moving fiber construction programs. Our Senior Manager, Controls & Governance will architect and lead the operational controls framework that enables consistent, predictable, and high-quality execution across OSP deployment. This role sits at the center of project delivery, systems, reporting, and is a major contributor to executive decision-making — ensuring leadership has real-time clarity into performance, risk, and execution health. This is not just a maintenance role. This is a build-and-elevate role. Responsibilities/Ownership: - Build the Controls Engine for OSP Delivery - Architect and implement governance and controls frameworks supporting fiber construction programs - Establish operational guardrails ensuring consistency across markets and teams - Create scalable mechanisms to monitor schedule, cost, quality, and execution health - Identify systemic risk patterns and implement preventative controls - Drive accountability and performance discipline across project teams Leadership & People Management - Build and manage a team of nine control PMs - Define team structure, roles, and capabilities required to support expanding OSP programs - Hold team members and cross-functional partners accountable to defined KPIs and delivery standards within the controls function - Establish and scale a high-performing Controls & Governance function aligned to business growth - Actively mentor team members, strengthening both technical capabilities and business judgment - Foster critical thinking, problem-solving, and systems-level ownership across the team - Continuously evolve team capabilities as systems, scale, and complexity increase - Encourage knowledge sharing and standardization across regions and programs Turn Data Into Decision Power - Design powerful/flexible dashboards providing real-time performance visibility - Translate complex operational data into clear insights and actions - Establish KPI frameworks measuring true delivery health - Enable leadership to identify risk, delays, and execution gaps quickly - Build reporting structures eliminating manual data inconsistencies Standardize How Work Gets Done - Drive consistent PMO workflows across the OSP lifecycle - Implement scalable templates, tools, and operating procedures - Reduce cycle time and rework through smarter process design - Ensure field execution and system workflows remain aligned - Lead change management tied to governance improvements Operate as a Cross-Functional Force Multiplier - Serve as a strategic partner to Construction, PMO, Engineering, Finance, and Systems - Align operational execution with reporting and system capabilities - Lead structured working sessions to close process and visibility gaps - Influence across multiple teams and leadership levels - Act as connective tissue between execution teams and leadership Continuously Raise the Bar - Mature governance models as scale increases - Identify automation opportunities and eliminate manual dependencies - Implement feedback loops refining tools and workflows - Build a culture of transparency and accountability - Set the standard for operational excellence Qualifications - Minimum of ten (10) years in networking, telecom, fiber construction, infrastructure deployment, and/or PMO environments - Minimum of five (5) years in senior program, operations, or governance leadership roles - Experience building or transforming operational controls and reporting frameworks - Demonstrated ability to standardize processes across complex organizations - Advanced expertise in Excel/Google Sheets and performance reporting - Strong executive communication and stakeholder influence skills Requirements - Deep familiarity with OSP fiber construction, and/or ISP networking delivery models - Experience with Salesforce, Sitetracker, or similar platforms - Background in PMO transformation or operational excellence - Experience building dashboards/reporting ecosystems from the ground up - Lean or Six Sigma experience Benefits - Excellent Health, Dental & Vision Insurance - Retirement 401(k) Savings Plan - Generous paid time off policy including paid parental leave

United States
$95.7K - $147.2K / year
Full TimeRemoteTeam 1,001-5,000Since 2006H1B No Sponsor

• Oversee clinical event intake, analyze trends, support malpractice carrier reporting, and collaborate cross-functionally to deliver insights to hospital partners • Receive, process, and accurately code SAFE hotline reports (near misses, adverse events, life saves) • Maintain electronic records and documentation for peer review and carrier reporting • Utilize risk management platforms such as Origami for event and claims reporting • Maintain clinician and hospital data in Clarity, Team Matrix, and other databases • Support data cleanup and process improvement initiatives • Prepare and submit reportable incidents and documentation to malpractice carriers • Ensure timely, accurate communication of claims-related information • Serve as a resource to clinicians, gathering event details and providing guidance • Provide backup support to Senior Risk Managers as needed • Analyze internal and external data (e.g., Candello) to identify risk mitigation opportunities • Develop reports highlighting trends, performance benchmarks, and organizational value • Coordinate retrieval of medical records and supporting documentation • Support Patient Advocacy Committee case preparation • Lead coordination of educational resources from external partners and insurers • Partner with Learning & Development to distribute risk and patient safety training

United States
$80K - $90K / year
Mastercard logo

Manager, Customer Fraud - Security/Risk Services

Mastercard

Founded in 1966, Mastercard is a worldwide transaction, payment-processing, and consulting company best known for its line of personal and business credit cards. As an employer, Ma

Risk1 day ago
Full TimeRemoteTeam 38,800Since 1966

Our Purpose Mastercard powers economies and empowers people in 200+ countries and territories worldwide. Together with our customers, we're helping build a sustainable economy where everyone can prosper. We support a wide range of digital payments choices, making transactions secure, simple, smart and accessible. Our technology and innovation, partnerships and networks combine to deliver a unique set of products and services that help people, businesses and governments realize their greatest potential. Title and Summary Manager, Customer Fraud - Security/Risk Services Job Description Summary The Franchise Customer Performance and Fraud Team's main role is to ensure that its member institutions are optimized in their processes, procedures, and tools to help them manage and reduce fraud on their portfolio and optimize their chargeback process. Through our many safety and security enhancing programs, we work proactively with our internal/ external key stakeholders, the industry and the public to build consumer confidence and ensure that transactions are as safe as they can be and our customers are in compliance with our rules and programs. Accountabilities • Responsible for the planning and delivery of all aspects of the fraud management effort to customers, merchants, payment facilitators, service providers and Mastercard cross functional business units.• Responsible for managing Compliance programs with customers and internal areas. • Conduct in-depth MIS analysis using internal Mastercard data.• Leverage Mastercard products and programs as well as industry "best practices" to assist customers in their efforts to mitigate fraud and comply with Mastercard rules and standards• Provides consultancy services and risk assessment to customers in the areas of fraud prevention, detection, chargeback and recovery• Provides investigative assistance to customers and law enforcement• Customer training and development Requirements • Risk management and/or fraud management experience• Experience in payments.• Strong analytical and communications skills• Ability to interact effectively with internal and external business partners• Good communication skills, both verbal and written - ability to build compelling presentations• Solutions oriented/ results driven capabilities• Proficient in English language• Periodic travel required• Bachelor's Degree Corporate Security Responsibility All activities involving access to Mastercard assets, information, and networks comes with an inherent risk to the organization and, therefore, it is expected that every person working for, or on behalf of, Mastercard is responsible for information security and must: - Abide by Mastercard's security policies and practices; - Ensure the confidentiality and integrity of the information being accessed; - Report any suspected information security violation or breach, and - Complete all periodic mandatory security trainings in accordance with Mastercard's guidelines.

Mexico
Full TimeRemoteTeam 201-500Since 2004H1B No Sponsor

• Support the global quotation and pricing process across different regions and service lines. • Coordinate RFQs, RFPs, and commercial proposals, ensuring accuracy, consistency, and timely delivery. • Maintain and apply standard quotation templates, pricing models, and commercial approval processes. • Partner with Business Development teams to create competitive and operationally realistic proposals. • Support the optimisation of quotation workflows, tools, and processes.

United States