Senior Regional Quality Operations Specialist

WelbeHealthLos Angeles, CA
Hybrid

About The Position

The Senior Regional Quality Operations Specialist plays a key role in driving regulatory compliance and continuous quality improvement across the organization. This role ensures effective management and follow-through of quality initiatives stemming from internal and external audits, complaint investigations, and performance assessments. The Senior Regional Quality Operations Specialist leads the coordination and implementation of corrective action plans (CAPs) and preventive measures, facilitates comprehensive root cause analyses (RCA) with cross-functional partners, and supports the design, execution, and evaluation of targeted quality improvement strategies. This role also ensures accurate and consistent collection and reporting of enterprise trends and analysis of CAP outcomes, progress of interventions, and risk assessment. This role is different because the Senior Regional Quality Operations Specialist at WelbeHealth: Plays a critical role in strengthening regulatory compliance and quality performance across markets, directly impacting participant safety and care outcomes in a highly regulated PACE environment. Leads complex, cross-functional quality initiatives, driving sustainable process improvements across clinical and operational teams.

Requirements

  • Bachelor’s degree in relevant field required; master’s degree preferred
  • Must be located in Los Angeles County for frequent travel to Southern California Markets
  • Minimum of three (3) years of experience in quality improvement/assurance in a healthcare setting, or in health or eldercare programs with oversight of quality/compliance
  • Previous experience with process improvement, risk assessment, and quality improvement methodologies (e.g., PDSA, Lean, Six Sigma)
  • Experience in or knowledge of healthcare compliance, PACE-specific program compliance, and HIPAA requirements required
  • Experience working with multidisciplinary teams required
  • Experience with managing data and conducting analyses using software including but not limited to productivity suite software, Smartsheet, and Power BI
  • Experience with electronic medical records, preferably Athena
  • Seeking a Senior Regional Quality Operations Specialist with experience in healthcare quality, compliance, and regulatory oversight (ideally within PACE, Medicare, or Medicaid environments), who can lead root cause analyses, drive corrective action plans, and partner across multidisciplinary teams to improve quality outcomes.

Responsibilities

  • Partner with QODs and market leadership to implement quality activities, ensuring compliance with federal, state, and contractual regulatory requirements
  • Collaborate with QODs, Executive Directors (EDs), and Medical Directors (MDs) to address regulatory findings and compliance issues at the market level
  • Lead and facilitate RCAs with required stakeholders to identify systemic issues and prevent recurrence
  • Support regulatory process improvement by ensuring that RCA outcomes are translated into actionable and measurable CAPs
  • Assist QODs in the development and implementation of CAPs following audit findings, complaints, or regulatory observations
  • Track, monitor, and validate the progress of CAPs to ensure timely completion and measurable improvement in compliance performance, as well as prepare summary reports for leadership review
  • Partner with QODs to evaluate the effectiveness of CAPs and ensure sustainability of improvements

Benefits

  • Medical insurance coverage (Medical, Dental, Vision)
  • 17 days of personal time off (PTO), 12 holidays observed annually, and 6 sick days
  • 401K savings + match
  • Comprehensive compensation package including base pay and bonus
  • Additional benefits
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