Senior Quality Operations Specialist, Audit

WelbeHealth, LLC.; California; Ibrido; USD 75.000 - 98.000; Tempo pieno

Vantaggi offerti da questo lavoro

401K match

Healthcare coverage

Additional benefits

Descrizione del lavoro

WelbeHealth, LLC. seeks a Senior Quality Operations Specialist, Audit to lead end-to-end PACE regulatory audits and readiness activities. You will coordinate cross-functional teams, review evidence for regulatory alignment, and drive timely responses and corrective actions.

The role emphasizes audit leadership, risk identification, and process improvements within a fast-paced healthcare setting. Travel is required to support diverse audits and regulatory activities.

Competenze

• Bachelor’s degree required; related field acceptable with experience in healthcare quality, regulatory, or audit.
• Minimum of three (3) years in healthcare quality, regulatory compliance, audit, or related functions; five (5) years preferred.
• Experience leading or coordinating regulatory audits, mock audits, accreditation reviews, or regulatory response efforts preferred.
• Experience in PACE, Medicare, Medicaid, or managed care environments preferred.
• Strong knowledge of regulatory audit methodologies and evidence validation.
• Ability to lead complex projects, manage multiple audits, and meet deadlines in a fast-paced setting.

Mansioni

• Lead planning, coordination, and execution of assigned PACE regulatory audits and audit readiness activities.
• Facilitate kickoff meetings, readiness sessions, deliverable reviews, and stakeholder communications.
• Review and validate audit documentation for completeness, accuracy, and regulatory alignment; identify gaps and risks.
• Provide onsite/virtual audit support, including logistics, interview coordination, and issue tracking.
• Develop and maintain audit plans, dashboards, and leadership updates for oversight and decision making.
• Mentor Audit Specialists and Coordinators and coordinate workloads to meet regulatory deadlines.
• Collaborate with clinical, operational, quality, and compliance leaders to support regulatory response and corrective actions.

Conoscenze

Regulatory compliance

Audit leadership

Project management

Stakeholder management

Formazione

Bachelor’s degree in healthcare administration, nursing, public health, business administration, health information management, regulatory affairs, quality management, compliance, or related field

Descrizione del lavoro

Senior Quality Operations Specialist, Audit

Remote, CA, USA

***This role requires the team member to reside in California or within approximately a 2-hour flight of California due to travel 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.

The Senior Quality Operations Specialist, Audit is accountable for leading PACE regulatory audits, mock audits, audit readiness activities, and related regulatory response efforts across the organization. This role serves as the primary operational lead for assigned audits, driving accountability, coordinating cross-functional audit activities, evaluating documentation and evidence, identifying and escalating risks, and supporting timely resolution of audit readiness gaps. The role also serves as a senior audit subject matter resource, providing guidance to Audit Specialists and Audit Coordinators and supporting the standardization and continuous improvement of audit processes, tools, and readiness practices.

This role is different because the Senior Quality Operations Specialist, Audit at WelbeHealth:

• Owns the end-to-end execution and oversight of complex PACE regulatory audits and audit readiness activities, serving as the primary operational lead from planning and evidence preparation through audit support, findings, regulatory response, and transition into corrective action
• Drives cross-functional audit readiness and regulatory response, partnering with clinical, operational, quality, and compliance leaders to identify risks and systemic gaps, strengthen accountability, resolve barriers, and use audit findings and data to improve processes and sustain organizational readiness

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:

• Lead the planning, coordination, and execution of assigned PACE regulatory audits, mock audits, and audit readiness activities, while serving as the primary operational lead and audit subject matter resource for complex or high-priority audits
• Facilitate audit kickoff meetings, readiness sessions, deliverable reviews, interview preparation activities, and stakeholder communications while managing document requests, evidence collection, submissions, and other audit-related workstreams
• Review and validate audit documentation and evidence for completeness, accuracy, organization, and regulatory alignment, while identifying readiness gaps, documentation deficiencies, operational barriers, and regulatory risks, partnering with stakeholders to drive resolution
• Provide onsite and virtual audit support, including audit logistics, center activities, interview coordination, issue tracking, document retrieval, and real‑time response management
• Develop and maintain audit plans, dashboards, tracking tools, reports, and leadership updates to support audit oversight, risk identification, and decision‑making
• Provide functional guidance, mentoring, and technical support to Audit Specialists and Audit Coordinators while partnering with the Audit, CAP & Monitoring Manager to coordinate workloads, support team readiness, and ensure regulatory deadlines and departmental priorities are met
• Collaborate with clinical, operational, quality, and compliance leaders, as well as the CAP & Monitoring team, to support regulatory response activities, transition of findings to corrective action processes, and ongoing organizational readiness

Job requirements include:

• Bachelor’s degree in healthcare administration, nursing, public health, business administration, health information management, regulatory affairs, quality management, compliance, or related field required; equivalent combination of education and progressive healthcare, regulatory, quality, compliance, or audit experience may be considered
• Minimum of three (3) years of experience in healthcare quality, regulatory compliance, audit, operational readiness, performance improvement, or related functions; five (5) years of experience preferred
• Experience leading or coordinating regulatory audits, mock audits, accreditation reviews, compliance assessments, readiness activities, or regulatory response efforts preferred
• Experience working in PACE, Medicare, Medicaid, managed care, healthcare operations, quality, regulatory, or compliance environment preferred
• Strong knowledge of regulatory audit methodologies, audit readiness practices, evidence validation, documentation standards, and regulatory response processes
• Demonstrated ability to independently lead complex projects, manage multiple concurrent audits, priorities, stakeholders, and deadlines in a fast-paced environment
• Strong facilitation, communication, stakeholder management, and relationship‑building skills, with the ability to effectively influence and collaborate across all levels of the organization

We are seeking a highly organized, analytical, and collaborative Senior Quality Operations Specialist, Audit who is passionate about regulatory compliance, audit readiness, and driving meaningful operational improvement. The ideal candidate brings strong project management, critical‑thinking, communication, and problem‑solving skills, with the ability to lead complex audits, manage competing priorities and stakeholders, identify risks and root causes, and drive timely and sustainable resolution. If you thrive in a fast‑paced environment, are comfortable navigating complexity and ambiguity, and are energized by using data, technology, and continuous improvement to strengthen regulatory readiness and operational performance, we’d love 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.

$74,612.76 - $98,488.84 USD

At 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 Inclusion

At 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.