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Salary: USD 74,612.76 - 98,488.84 / annual
WelbeHealth is seeking a Senior Quality Operations Specialist, CAP & Monitoring to lead the development, implementation, and monitoring of corrective action plans (CAPs) resulting from PACE regulatory audits and compliance reviews. Reporting to the Quality Operations Director, you will own the end-to-end lifecycle of CAPs—from root cause analysis and remediation planning through implementation, monitoring, validation, and sustained closure.
You will serve as a cross-functional driver of regulatory remediation, partnering with operational, clinical, compliance, and quality leaders to identify risks, remove barriers, strengthen accountability, and use data to validate that corrective actions are effective and sustainable.
Day-to-day responsibilities include:
- Leading development, implementation, monitoring, and validation of CAPs from PACE audits, mock audits, monitoring activities, complaints, and compliance reviews
- Proactively identifying and escalating risks, overdue actions, implementation challenges, and systemic issues
- Partnering with center and departmental leadership to develop remediation strategies, establish timelines, resolve barriers, and drive timely completion
- Facilitating CAP meetings, root cause analysis sessions, and remediation workgroups
- Reviewing documentation, monitoring results, and evidence to assess implementation effectiveness and regulatory compliance
- Developing and maintaining CAP dashboards, tracking tools, reports, and status updates
- Leveraging data, monitoring results, and performance metrics to identify trends, risks, and improvement opportunities
- Identifying opportunities to use AI and technology to automate workflows and improve operational effectiveness
- Supporting PACE regulatory audits, mock audits, complaint investigations, and other Quality Operations initiatives
- Traveling to WelbeHealth centers as needed, including occasional overnight stays
Requirements:
- Bachelor's degree in healthcare administration, nursing, public health, business administration, health information management, regulatory affairs, quality management, compliance, or related field (master's degree preferred)
- Minimum 3 years of experience in healthcare quality, compliance, auditing, performance improvement, corrective action management, or related operations (5 years preferred)
- Experience developing, implementing, monitoring, and sustaining regulatory CAPs
- Experience with root cause analysis, PACE, Medicare, Medicaid, managed care, healthcare operations, quality, or compliance (preferred)
- Experience with process improvement and quality improvement methodologies (PDSA, Lean, Six Sigma) preferred
- Experience developing dashboards, reports, tracking tools, and performance measures; Power BI experience preferred
- Strong data-driven approach and critical-thinking skills
- Ability to use AI and technology to automate workflows and improve operational efficiency
- Strong project management, communication, and problem-solving skills
- Ability to manage multiple CAPs and engage cross-functional stakeholders
- Comfort navigating complexity and ambiguity in a fast-paced environment
