Regional Quality Operations Specialist

This role will be responsible for the oversight of our WelbeHealth Centers in San Jose, Long beach and Carson. This person must be comfortable with travel 1-2x a quarter based on business needs.

WelbeHealth PACE helps seniors stay in their homes and communities by providing medical care and community-based services. We believe in going the extra mile and aim to make a genuine difference in our participants’ lives.

Under the direct supervision of the Quality Operations Director (QOD), and in close collaboration with the VP of Quality Operations, Executive Directors (EDs), and Medical Directors (MDs), the WelbeHealth Regional Quality Operations Specialist is accountable for the maintenance and implementation of the WelbeHealth Quality Operations program. This role monitors staff compliance with state and federal regulations and WelbeHealth policies and procedures, as well as supports WelbeHealth audits.

This role is different because the Regional Quality Operations Specialist at WelbeHealth:

• Partners directly with EDs, MDs, and CMS-facing stakeholders to drive real-time compliance, audit readiness, root cause analyses (RCAs), and corrective action execution across entire markets, unlike traditional quality roles that operate in siloed hospital or health plan environments
• Goes beyond auditing - analyzing market-level data trends, leading regulatory process improvement initiatives, supporting CMS and state audits, and helping shape Quality Improvement Committee strategy

We care about our team members. That’s why we offer:

• Medical insurance coverage (Medical, Dental, Vision)
• Work/life balance - We mean it! 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
• And additional benefits!

On the day-to-day, you will:

• Onboard and mentor new quality specialist team members
• Collaborate with the QOD and market team members on market-level process improvement initiatives, as well as highlight data trends to QOD, EDs, or market leaders for process improvement opportunities
• Support regulatory process improvement, such as leading RCAs, and conduct additional market-level audits as assigned
• Analyze and review reports of market-level data, including those specified in the QI plan and required by state and federal regulations
• Provide support through the preparation for and successful completion of all state, federal, and mock audits
• Partner with the QOD to manage the preparation, implementation, and follow-up of all QI Program Committees, including the Quality Improvement Committee and Participant Advisory Committee

Job Requirements Include:

• Bachelor’s degree in relevant field; five (5) years of professional experience may be substituted; master’s degree in relevant field preferred
• Minimum of two (2) years of experience in quality improvement/assurance in a healthcare setting with oversight of quality/compliance
• Experience in or knowledge of healthcare compliance, including PACE-specific program compliance and HIPAA requirements, strongly preferred
• Experience with working with multidisciplinary teams required
• Experience with managing data and conducting analyses using software including but not limited to productivity suite software, Smartsheets, and Power BI
• Experience with Electronic Medical Records, preferably Athena
• Highly motivated, self-directed, able to execute tasks in a quickly changing environment, and able to make sound decisions in critical situations

We are seeking a Regional Quality Operations Specialist with at least two (2) years of experience in healthcare quality improvement, assurance, or compliance, preferably within PACE or highly regulated healthcare environments. If you are passionate about operational excellence and protecting high-quality care for vulnerable seniors, we’d love to hear from you.