Senior Quality Operations Specialist, CAP & Monitoring

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the creation, execution, monitoring, and validation of Corrective Action Plans (CAPs) arising from PACE regulatory audits, mock audits, monitoring activities, complaints, and other compliance-related evaluations.

• Recognize and escalate risks, overdue actions, implementation challenges, and systemic concerns.

• Collaborate with center and departmental leadership to formulate remediation strategies, set timelines, overcome obstacles, and ensure the prompt completion of corrective actions.

• Conduct CAP meetings, root cause analyses, and remediation workgroups.

• Evaluate documentation, monitoring outcomes, and evidence submissions to determine the effectiveness of implementation, sustainability, and regulatory compliance.

• Create and sustain CAP dashboards, tracking tools, reports, and status updates.

• Utilize data, monitoring outcomes, and performance metrics to uncover trends, risks, and opportunities for continuous enhancement.

• Spot opportunities to utilize AI and technology for workflow automation and operational efficiency improvement.

• Assist in PACE regulatory audits, mock audits, complaint investigations, and other Quality Operations endeavors.

⛳️ Requirements

• A Bachelor’s degree in healthcare administration, nursing, public health, business administration, health information management, regulatory affairs, quality management, compliance, or a related field is required.

• Prior experience with process improvement, risk assessment, and quality improvement methodologies (e.g., PDSA, Lean, Six Sigma) is preferred.

• At least three (3) years of experience in healthcare quality, compliance, auditing, performance improvement, corrective action management, or related operations; five (5) years of experience is preferred.

• Experience in developing, implementing, monitoring, and sustaining regulatory CAPs.

• Familiarity with RCA, PACE, Medicare, Medicaid, managed care, healthcare operations, quality, or compliance is preferred.

• Experience in creating dashboards, reports, tracking tools, and performance measures; experience with Power BI is preferred.

• Strong data-driven mindset and critical thinking abilities, including trend identification, risk evaluation, root cause determination, and actionable recommendation development.

• Capability to use AI and technology to automate workflows, streamline processes, and enhance operational efficiency and effectiveness.

• Willingness to travel to WelbeHealth centers as required for business-related tasks, including occasional overnight stays.

• Proof of vaccination, or a vaccine declination form, is required prior to employment.

🏝️ 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

• Additional benefits