Senior Director Of Quality Operations & Compliance

***Candidates must reside in California, preferably in Northern California
or within a 2-hour direct flight of Sacramento, with the ability to travel onsite as needed for business and regulatory requirements***At WelbeHealth, we serve our communities’ most vulnerable seniors through shared intention, pioneering spirit, and the courage to love. These core values and our participant-focus lead the way no matter what.Under the direct supervision of the Vice President, Quality Operations, the Director, Quality Operations develops and implements an effective and robust PACE quality program that ensures WelbeHealth participants are uniquely cared for. As a compliance leader and driver of care excellence, the Director, Quality Operations oversees Quality Operations activities, leads Quality Operations teams, and effectively communicates quality results to team members, the board and its committees, and regulatory agencies. The Director, Quality Operations continuously identifies education and training opportunities to improve team member performance.This role is different because the Director, Quality Operations at WelbeHealth:Leads enterprise-wide quality strategy and compliance excellence - driving the design, implementation, and continuous improvement of the PACE quality program, directly impacting participant safety, regulatory readiness, and care outcomesPartners cross-functionally to turn data into action – collaborating with Analytics, Compliance, and Operations teams to translate complex data into actionable insights, strengthen performance, and elevate quality across the organizationWe 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 days401K savings + matchComprehensive compensation package including base pay and bonusAnd additional benefits!On the day-to-day, you will:Collaborate with the VP, Quality Operations to develop and standardize enterprise metrics in clinical excellence, quality, and patient safety in alignment with all policies and procedures, as well as local, state, federal, and CDC guidelinesCollaborate with the VP, Quality Operations and other Directors, Quality Operations to develop standardized quality operations workflows, playbooks, tools, and other quality operations resources, as well as to implement standardized and scalable approaches to collecting data, analyzing data, and generating data visualizations and reportsPartner with Analytics and Performance Excellence Teams to analyze and review operational performance for continuous process improvements, increased efficiency, and participant satisfactionMonitor and analyze data including quality improvement (QI) plan metrics, HPMS entries, company and market initiatives, and corrective action plans (CAPs) to identify trends and areas for process improvementAct as a QI subject matter expert on program and company initiatives as needed, such as collaborating with the Compliance team on initiatives to monitor and improve compliance issues, CAPs, and the Fraud, Waste, and Abuse programCollaborate with the Quality Operations team and Compliance Officer to ensure PACE program complaints are appropriately investigated, responded to, and documented, as well as support PACE program procedures to process grievances and complaints in accordance with applicable state and federal regulations, policies and procedures, and compliance standardsEnsure complete and timely submission of all information required by regulatory agencies including but not limited to HPMS quality reporting, CMS Quarterly calls, enrollment denials, and audit requirementsJob requirements include:Bachelor’s degree in relevant field;
professional experiencemay be substituted;
master’s degree in relevant field preferredExperience as Lean Six Sigma green belt or black belt preferred;
formal QI and analyticscertifications preferredFive (5) years of experience required, three (3) years of which must be as a QI/assurance Director/Manager in a healthcare setting, or in managing health/elder care programs with oversight of QI or complianceThree (3) years of supervisory experience with demonstrated ability to mentor and develop team membersHands-on experience working with the California DHCS and navigating state-level regulatory expectations;
experience working withand implementing PACE regulations preferredExperience with regulatory compliance and audits required, including preparing for and responding to CMS, DHCS, and other state/federal regulatory reviewsDemonstrated experience developing, implementing, and managing QI plans in alignment with regulatory requirementsExperience and exceptional capabilities managing data and conducting analyses using productivity suite software including complex spreadsheets and data visualization tools;
Excel and PowerBI experience a plusExperience developing, managing, and monitoring CAPs to address compliance and quality issues;
proven ability to lead process improvement initiatives, identify gaps, and implement sustainable operational enhancementsWe are seeking a Director, Quality Operations who is passionate about advancing quality, driving compliance, and leading high-impact initiatives that improve participant outcomes and strengthen organizational performance. Ifyou’reready to join a team that values both its participants and team members,we’dlove to hear from you!Compensation consists of base salary plus bonus. WelbeHealth offers a competitive total rewards package that includes a 401(k) match, comprehensive healthcare coverage, and a broad range of additional benefits. Actual compensation will be determined based on experience and relevant qualifications.$159,939.07 - $211,119.57 USDAt WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations.Our Commitment to Diversity, Equity and InclusionAt WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.Beware of ScamsPlease ensure your application is being submitted through a WelbeHealth sponsored site only. Our emails will come from @welbehealth.Com email addresses. You will never be asked to purchase your own employment equipment. You can report suspected scam activity to View email address on ca.hrm.tc a Job AlertInterested in building your career at WelbeHealth? Get future opportunities sent straight to your email.Accepted file types: pdf, doc, docx, txt, rtfEnter manuallyAccepted file types: pdf, doc, docx, txt, rtfDo you have at least five (5) years of experience in healthcare quality improvement, assurance, or compliance? * Select...Do you have at least three (3) years of experience in a leadership role (Director/Manager) overseeing Quality Improvement (QI) or compliance programs in a healthcare setting? * Select...Do you have at least three (3) years of direct people management experience, including mentoring and developing team members? * Select...Do you have hands-on experience working with the California Department of Health Care Services (DHCS) and navigating state-level regulatory requirements? * Select...Do you have experience preparing for and responding to regulatory audits (e.G., CMS, DHCS, state/federal agencies)? * Select...Are you currently located in California or within a 2-hour direct flight of Los Angeles, with the ability to travel onsite as needed? * Select...What is your highest level of education completed? * Select...Do you hold any of the following certifications? (Select all that apply) *Quality Improvement (QI) CertificationAnalytics/Data CertificationNonePlease describe your experience leading Quality Improvement (QI) or compliance programs in a healthcare or PACE environment. What was your scope and impact? *Describe your experience working with DHCS and/or CMS. What types of regulatory interactions or submissions have you managed? *Please provide your LinkedIn Profile as a part of your application. *What is your desired pay? *For example: $XX.XX hourly or $XX,XXX annuallyHave you been referred by a current WelbeHealth employee? * Select...If you were referred, please specify the referring individual's first and last name. Otherwise, enter “N/A." *Are you a current employee of WelbeHealth? * Select...Do any of your relatives currently work for or at WelbeHealth? If so, who? *Texting Consent Policy * Select...Do you consent to receiving text messages as part of the recruitment process? By selecting Yes, you agree to receive SMS from WelbeHealth. Reply STOP to opt out at any time. Reply HELP for customer care contact information. Message and data rates may apply. Messaging frequency will vary. Visit welbehealth.Com/privacy-policy/ to see our Privacy Policy. Visit careers.Welbehealth.Com/us/en/emailpersonalinfo for our Terms of Service.Have you ever worked for WelbeHealth? * Select...Will you now or in the future require employer-sponsored work authorization or visa sponsorship to legally work in the United States?Applicants must be legally authorized to work in the United States without current or future employer sponsorship. At this time, WelbeHealth does not provide any employment-based visa sponsorship, including H-1B, TN, E-3, O-1, F-1 OPT/STEM OPT, or other employment-based work authorization. * Select...Voluntary Self-Identification
For government reporting purposes, we ask candidates to respond to the below self-identification survey.Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiringprocess or thereafter. Any information that you do provide will be recorded and maintained in aconfidential file.As set forth in WelbeHealth’s Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measurethe effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categoriesis as follows:A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs;
or a person who was discharged or released from active duty because of a service-connected disability.A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
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