Senior Quality Operations Specialist, Audit

🔥 2 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $74.6k - $98.5k / year

⏰ Full Time

🟠 Senior

⚙️ Operations

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WelbeHealth

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

💰 $30M Series C on 2020-02

Healthcare • Healthcare Insurance

WelbeHealth is a healthcare organization that provides comprehensive medical care and personalized support to help seniors age well at home and in their communities. They offer a Program of All-Inclusive Care for the Elderly (PACE) which includes services such as medical care and coordination, dental, vision and hearing services, in-home care, prescription deliveries, transportation, physical therapy, meals, social activities, and more, often at no cost to eligible seniors. WelbeHealth's dedicated team prioritizes the needs of seniors by offering a coordinated approach to healthcare, ensuring access to highly skilled professionals across various areas of healthcare, and emphasizing patient-centered care. Their goal is to improve the quality of life for seniors by enabling them to live independently with robust support from a multidisciplinary team.

📋 Description

• Lead planning, coordination, and execution of assigned PACE regulatory audits, mock audits, and audit readiness activities • Serve as primary operational lead and audit subject matter resource for complex or high-priority audits • Facilitate audit kickoff meetings, readiness sessions, deliverable reviews, interview preparation, and stakeholder communications • Manage document requests, evidence collection, submissions, and audit-related workstreams • Review and validate audit documentation and evidence for completeness, accuracy, organization, and regulatory alignment • Identify readiness gaps, documentation deficiencies, operational barriers, and regulatory risks, and drive resolution with stakeholders • Provide onsite and virtual audit support, including 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 • Provide guidance, mentoring, and technical support to Audit Specialists and Audit Coordinators • Collaborate with clinical, operational, quality, compliance, and CAP & Monitoring teams on regulatory response, corrective action, and organizational readiness • Support standardization and continuous improvement of audit processes, tools, and readiness practices

🎯 Requirements

• 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 • 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 • Ability to independently lead complex projects and manage multiple concurrent audits, priorities, stakeholders, and deadlines • Strong facilitation, communication, stakeholder management, and relationship-building skills • Must reside in California or within approximately a 2-hour flight of California due to travel requirements • Proof of COVID-19 vaccination or a vaccine declination form 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 • COVID-19 vaccination policy and infection control/PPE standards