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Salary: USD 26.89 - 35.5 / hourly
WelbeHealth is a value-based healthcare organization transforming senior care through PACE (Programs of All-Inclusive Care for the Elderly) programs. The Quality Operations Coordinator reports to the Quality Operations Supervisor and plays a critical role in ensuring the completeness, accuracy, timeliness, and regulatory compliance of participant medical records.
Day-to-day responsibilities include:
- Conducting comprehensive medical records audits to verify all required documentation is present, accurate, and timely
- Identifying deficiencies in electronic health records (EHR) and facilitating corrections to ensure data integrity
- Monitoring participant records and reporting policy/procedure violations to the Quality Operations Supervisor
- Preparing audit documentation for desk review submissions, including universe lists and EMR navigation support
- Reviewing and reconciling assigned regulatory logs
- Completing required investigations and notifications
- Participating in team documentation initiatives and process improvement projects
- Supporting WelbeHealth's audit readiness efforts
This role combines quality auditing with process improvement, giving you the opportunity to identify trends, investigate root causes, and collaborate with clinical and operational teams to strengthen documentation practices and support regulatory compliance across the PACE organization. Your work directly impacts the quality and safety of care for vulnerable seniors.
Requirements:
- Associate's degree preferred; may substitute three years' work 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 operational controls in regulated environments
- Experience with grievances, complaints, appeals, or member/provider issues in healthcare, health plans, managed care, PACE, or other regulated healthcare environments (highly desired)
- Bilingual capability (a plus)
- Ability to multitask in a challenging environment
- Excellent communication, listening, and organizational skills
- Intermediate to advanced proficiency with MS Office Suite
