Director, Quality Operations & Compliance (PACE) - CA

WelbeHealth; United States; Remote; USD 160.000 - 211.000; Vollzeit

Benefits dieser Stelle

Medical insurance coverage (Medical, R

PTO: 17 days

Holidays: 12

Sick days: 6

401K savings + match

Comprehensive compensation package

Additional benefits

Zusammenfassung

WelbeHealth seeks a Director, Quality Operations to lead enterprise-wide quality programs in PACE, driving safety, compliance, and care outcomes. You will partner with Analytics, Compliance, and Operations to translate data into improvements, develop scalable processes, and elevate quality across the organization.

The role requires deep QA/QI leadership, strong regulatory experience with California DHCS and CMS, and a proven ability to mentor teams while advancing performance and participant

Qualifikationen

• Bachelor’s degree in relevant field; master’s preferred
• Lean Six Sigma green/black belt preferred; QI analytics certifications preferred
• Five years in healthcare QI/assurance or managed health/elder care programs with QI/compliance oversight
• Three years of supervisory experience with mentoring
• Experience with California DHCS regulatory expectations and PACE regulations
• Regulatory audits preparation and response experience
• Experience building, managing, and monitoring CAPs and quality improvement plans
• Experience using data analytics tools including Excel and Power BI

Aufgaben

• Develop and standardize enterprise metrics in clinical excellence, quality, and patient safety
• Create standardized quality operations workflows, playbooks, and data collection tools
• Analyze performance with Analytics and Performance Excellence teams for improvements
• Monitor HPMS, CMS calls, enrollment denials, and audit requirements for trends and actions
• Lead QI initiatives and collaborate on compliance improvements with the Compliance team
• Ensure timely investigation and documentation of PACE program complaints and grievances
• Support regulator requirements and quality reporting across state and federal programs

Kenntnisse

Quality operations leadership

Data analysis & visualization

Regulatory compliance

Cross-functional collaboration

Program management

Ausbildung

Bachelor’s degree in relevant field

Master’s degree preferred

Tools

Power BI

Excel

HPMS reporting tools

CAPs tracking system

Jobbeschreibung

WelbeHealth seeks a Director, Quality Operations to lead enterprise-wide quality programs in PACE, driving safety, compliance, and care outcomes. You will partner with Analytics, Compliance, and Operations to translate data into improvements, develop scalable processes, and elevate quality across the organization.

The role requires deep QA/QI leadership, strong regulatory experience with California DHCS and CMS, and a proven ability to mentor teams while advancing performance and participant