Senior Quality Operations Specialist, Audit

WelbeHealth•Remote, CA, USA, CA

4h•$74,613 - $98,489•Remote

About The Position

This role requires the team member to reside in California or within approximately a 2-hour flight of California due to travel requirements. At WelbeHealth, we serve our communities’ most vulnerable seniors through shared intention, pioneering spirit, and the courage to love. These core values and our participant focus lead the way no matter what. The Senior Quality Operations Specialist, Audit is accountable for leading PACE regulatory audits, mock audits, audit readiness activities, and related regulatory response efforts across the organization. This role serves as the primary operational lead for assigned audits, driving accountability, coordinating cross-functional audit activities, evaluating documentation and evidence, identifying and escalating risks, and supporting timely resolution of audit readiness gaps. The role also serves as a senior audit subject matter resource, providing guidance to Audit Specialists and Audit Coordinators and supporting the standardization and continuous improvement of audit processes, tools, and readiness practices. This role is different because the Senior Quality Operations Specialist, Audit at WelbeHealth: Owns the end-to-end execution and oversight of complex PACE regulatory audits and audit readiness activities, serving as the primary operational lead from planning and evidence preparation through audit support, findings, regulatory response, and transition into corrective action. Drives cross-functional audit readiness and regulatory response, partnering with clinical, operational, quality, and compliance leaders to identify risks and systemic gaps, strengthen accountability, resolve barriers, and use audit findings and data to improve processes and sustain organizational readiness.

Requirements

Bachelor's degree in healthcare administration, nursing, public health, business administration, health information management, regulatory affairs, quality management, compliance, or related field required; equivalent combination of education and progressive healthcare, regulatory, quality, compliance, or audit experience may be considered
Minimum of three (3) years of experience in healthcare quality, regulatory compliance, audit, operational readiness, performance improvement, or related functions; five (5) years of experience preferred
Experience leading or coordinating regulatory audits, mock audits, accreditation reviews, compliance assessments, readiness activities, or regulatory response efforts preferred
Experience working in PACE, Medicare, Medicaid, managed care, healthcare operations, quality, regulatory, or compliance environment preferred
Strong knowledge of regulatory audit methodologies, audit readiness practices, evidence validation, documentation standards, and regulatory response processes
Demonstrated ability to independently lead complex projects, manage multiple concurrent audits, priorities, stakeholders, and deadlines in a fast-paced environment
Strong facilitation, communication, stakeholder management, and relationship-building skills, with the ability to effectively influence and collaborate across all levels of the organization

Nice To Haves

five (5) years of experience preferred
Experience leading or coordinating regulatory audits, mock audits, accreditation reviews, compliance assessments, readiness activities, or regulatory response efforts preferred
Experience working in PACE, Medicare, Medicaid, managed care, healthcare operations, quality, regulatory, or compliance environment preferred

Responsibilities

Lead the planning, coordination, and execution of assigned PACE regulatory audits, mock audits, and audit readiness activities, while serving as the primary operational lead and audit subject matter resource for complex or high-priority audits
Facilitate audit kickoff meetings, readiness sessions, deliverable reviews, interview preparation activities, and stakeholder communications while managing document requests, evidence collection, submissions, and other audit-related workstreams
Review and validate audit documentation and evidence for completeness, accuracy, organization, and regulatory alignment, while identifying readiness gaps, documentation deficiencies, operational barriers, and regulatory risks, partnering with stakeholders to drive resolution
Provide onsite and virtual audit support, including audit logistics, center activities, interview coordination, issue tracking, document retrieval, and real-time response management
Develop and maintain audit plans, dashboards, tracking tools, reports, and leadership updates to support audit oversight, risk identification, and decision-making
Provide functional guidance, mentoring, and technical support to Audit Specialists and Audit Coordinators while partnering with the Audit, CAP & Monitoring Manager to coordinate workloads, support team readiness, and ensure regulatory deadlines and departmental priorities are met
Collaborate with clinical, operational, quality, and compliance leaders, as well as the CAP & Monitoring team, to support regulatory response activities, transition of findings to corrective action processes, and ongoing organizational readiness