Senior Quality Operations Specialist, CAP & Monitoring
About The Position
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. Under the direct supervision of the Quality Operations Director, the Senior Quality Operations Specialist, CAP & Monitoring leads the development, implementation, and monitoring of corrective action plans (CAPs) related to PACE regulatory audit findings. This role partners with Operational, Clinical, Compliance, and Quality leaders to drive accountability, resolve barriers, support timely closure, and validate sustained compliance. The Senior Quality Operations Specialist, CAP & Monitoring manages multiple CAPs, analyzes monitoring results, escalates risks, and supports continuous improvement. This role is different because the Senior Quality Operations Specialist, CAP & Monitoring at WelbeHealth: Owns the end-to-end lifecycle of CAPs resulting from PACE regulatory audits, monitoring activities, complaints, and other compliance reviews from root cause analysis (RCA) and remediation planning through implementation, monitoring, validation, and sustained closure. Serves as a cross-functional driver of regulatory remediation, partnering with leaders to identify risks, remove barriers, strengthen accountability, and use data and monitoring results to validate that corrective actions are effective and sustainable.
Requirements
- Bachelor’s degree in healthcare administration, nursing, public health, business administration, health information management, regulatory affairs, quality management, compliance, or related field required; master’s degree preferred
- Minimum of three (3) years of experience in healthcare quality, compliance, auditing, performance improvement, corrective action management, or related operations; five (5) years of experience preferred
- Experience developing, implementing, monitoring, and sustaining regulatory CAPs
- Experience in RCA, PACE, Medicare, Medicaid, managed care, healthcare operations, quality, or compliance preferred
- Experience developing dashboards, reports, tracking tools, and performance measures; Power BI experience preferred
- Strong data-driven approach and critical-thinking skills, including identifying trends, evaluating risks, determining root causes, and developing actionable recommendations
- Ability to use AI and technology to automate workflows, streamline processes, and improve operational efficiency and effectiveness
- Travel to WelbeHealth centers as needed to support business-related activities, including occasional overnight stays
Nice To Haves
- Previous experience with process improvement, risk assessment, and quality improvement methodologies (e.g., PDSA, Lean, Six Sigma) preferred
Responsibilities
- Lead the development, implementation, monitoring, and validation of CAPs resulting from PACE regulatory audits, mock audits, monitoring activities, complaints, and other compliance-related reviews, as well as proactively identify and escalate risks, overdue actions, implementation challenges, and systemic issues
- Partner with center and departmental leadership to develop remediation strategies, establish timelines, resolve barriers, and drive timely completion of corrective actions
- Facilitate CAP meetings, RCA, and remediation workgroups to support accountability and progress toward closure
- Review documentation, monitoring results, and evidence submissions to assess implementation effectiveness, sustainability, and compliance with regulatory requirements
- Develop and maintain CAP dashboards, tracking tools, reports, and status updates, as well as leverage data, monitoring results, and performance metrics to identify trends, risks, and opportunities for continuous improvement
- Identify opportunities to leverage AI and technology to automate workflows and improve operational effectiveness
- Support PACE regulatory audits, mock audits, complaint investigations, and other Quality Operations initiatives as assigned
Benefits
- Medical insurance coverage (Medical, Dental, Vision)
- 17 days of personal time off (PTO)
- 12 holidays observed annually
- 6 sick days
- 401K savings + match
- Comprehensive compensation package including base pay and bonus
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What This Job Offers
Job Type
Full-time
Career Level
Senior
