Senior Quality Operations Specialist, CAP & Monitoring

The role

The Senior Quality Operations Specialist, CAP & Monitoring leads the development, implementation, and monitoring of corrective action plans related to PACE regulatory audit findings. This role partners with cross-functional leaders to drive accountability, resolve barriers, and validate sustained compliance.

What you will do

• Lead the development, implementation, monitoring, and validation of CAPs from regulatory audits, mock audits, and complaints
• Partner with center and departmental leadership to develop remediation strategies and timelines
• Facilitate CAP meetings, RCA, and remediation workgroups
• Review documentation and monitoring results to assess implementation effectiveness and compliance
• Develop and maintain CAP dashboards, tracking tools, reports, and status updates
• Identify opportunities to leverage AI and technology to automate workflows
• Support PACE regulatory audits, mock audits, and complaint investigations

Required qualifications

• Bachelor’s degree in healthcare administration, nursing, public health, business administration, health information management, regulatory affairs, quality management, compliance, or related field
• Minimum of three (3) years of experience in healthcare quality, compliance, auditing, performance improvement, corrective action management, or related operations
• Experience developing, implementing, monitoring, and sustaining regulatory CAPs
• Strong data-driven approach and critical-thinking skills
• Ability to use AI and technology to automate workflows, streamline processes, and improve operational efficiency and effectiveness

Nice to have

• master's degree
• Previous experience with process improvement, risk assessment, and quality improvement methodologies (e.g., PDSA, Lean, Six Sigma)
• Experience in RCA, PACE, Medicare, Medicaid, managed care, healthcare operations, quality, or compliance
• Experience developing dashboards, reports, tracking tools, and performance measures
• Power BI experience

Benefits

• Medical insurance coverage (Medical, Dental, Vision)
• 17 days of personal time off (PTO)
• 12 holidays observed annually
• 6 sick days
• 401K savings + match
• Base pay and bonus

Before you apply

• Proof of vaccination, or a vaccine declination form will be required prior to employment

About the company

WelbeHealth serves communities’ most vulnerable seniors through shared intention, pioneering spirit, and the courage to love.