Quality Operations Coordinator

WelbeHealth•Remote, CA, USA, CA

1d•$27 - $36•Onsite

About The Position

WelbeHealth is a value-based healthcare organization that’s transforming the future of senior care by providing an all-inclusive care option to our most vulnerable senior population. We step in as the care provider and care planner that work to keep our participants within their communities, out of institutions, and cared for like family, all while receiving the healthcare and social services needed to thrive. Under the supervision of the Quality Operations Supervisor, the Quality Operations Coordinator (QOC) will be responsible for delivering excellent support and service to our PACE market operations through a process of record review to ensure a complete and accurate participant medical record. Responsibilities will include collecting data, auditing participant electronic health records by utilizing comprehensive tools specific to the area of quality improvement, complete reporting and confirming all regulatory required elements. This role collaborates effectively with colleagues and stakeholders to promote the WelbeHealth values, team culture and mission. This role is different because the Quality Operations Coordinator at WelbeHealth: Plays a direct role in the quality and accuracy of participant care, ensuring medical records are complete, accurate, timely, and compliant with regulatory requirements. Your work helps identify gaps in documentation and supports our care teams in maintaining the highest standards of quality for our participants. Combines quality auditing with meaningful process improvement, giving you the opportunity to identify trends and deficiencies, investigate root causes, and collaborate with clinical and operational teams to strengthen processes, improve documentation, and support regulatory readiness across the PACE organization.

Requirements

Associate’s degree preferred; may substitute three years’ experience in lieu of education
Minimum two (2) years’ work experience in a healthcare setting or related areas
Familiarity with healthcare quality standards, auditing, regulatory requirements, documentation, and maintaining operational controls in a regulated environment
Experience working with grievances, complaints, appeals, or member/provider issues within a healthcare, health plan, managed care, PACE, or other regulated healthcare environment is highly desired
Bilingual is a plus
Ability to multi-task in a challenging environment is necessary; Excellent communication, listening, and organization skills
Extensive MS office suite experience (Intermediate to advanced level proficiency is desired)

Nice To Haves

Bilingual is a plus
Extensive MS office suite experience (Intermediate to advanced level proficiency is desired)

Responsibilities

Identify potential deficiencies, facilitate, and monitor appropriate corrections to ensure data integrity in the EHR. Monitor participant medical records for complete and timely documentation and promptly report to Quality Operations Supervisor when policies and procedures are not being followed
Participate in team documentation, process improvements and other QO team initiatives
Conduct medical records audits to ensure all required documentation is timely and accurate
Assist with WelbeHealth audits by preparing documents for desk review submission (universe lists) as well as assist with EMR navigation and impact analysis
Review and reconcile assigned regulatory logs
Complete all required tasks in a timely and accurate manner
Complete required investigations and notifications