Senior Quality Operations Specialist, CAP & Monitoring

Job DescriptionJob DescriptionAt 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 Quality Operations Director, the Senior Quality Operations Specialist, CAP & Monitoring leads the development, implementation, and monitoring of corrective action plans (CAPs) related to PACE regulatory audit findings. This role partners with Operational, Clinical, Compliance, and Quality leaders to drive accountability, resolve barriers, support timely closure, and validate sustained compliance. The Senior Quality Operations Specialist, CAP & Monitoring manages multiple CAPs, analyzes monitoring results, escalates risks, and supports continuous improvement.This role is different because the Senior Quality Operations Specialist, CAP & Monitoring at WelbeHealth:Owns the end-to-end lifecycle of CAPs resulting from PACE regulatory audits, monitoring activities, complaints, and other compliance reviews from root cause analysis (RCA) and remediation planning through implementation, monitoring, validation, and sustained closureServes as a cross-functional driver of regulatory remediation, partnering with leaders to identify risks, remove barriers, strengthen accountability, and use data and monitoring results to validate that corrective actions are effective and sustainableWe 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:Lead the development, implementation, monitoring, and validation of CAPs resulting from PACE regulatory audits, mock audits, monitoring activities, complaints, and other compliance-related reviews, as well as proactively identify and escalate risks, overdue actions, implementation challenges, and systemic issuesPartner with center and departmental leadership to develop remediation strategies, establish timelines, resolve barriers, and drive timely completion of corrective actionsFacilitate CAP meetings, RCA, and remediation workgroups to support accountability and progress toward closureReview documentation, monitoring results, and evidence submissions to assess implementation effectiveness, sustainability, and compliance with regulatory requirementsDevelop and maintain CAP dashboards, tracking tools, reports, and status updates, as well as leverage data, monitoring results, and performance metrics to identify trends, risks, and opportunities for continuous improvementIdentify opportunities to leverage AI and technology to automate workflows and improve operational effectivenessSupport PACE regulatory audits, mock audits, complaint investigations, and other Quality Operations initiatives as assignedJob 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; master's degree preferredPrevious experience with process improvement, risk assessment, and quality improvement methodologies (e.g., PDSA, Lean, Six Sigma) preferredMinimum of three (3) years of experience in healthcare quality, compliance, auditing, performance improvement, corrective action management, or related operations; five (5) years of experience preferredExperience developing, implementing, monitoring, and sustaining regulatory CAPsExperience in RCA, PACE, Medicare, Medicaid, managed care, healthcare operations, quality, or compliance preferredExperience developing dashboards, reports, tracking tools, and performance measures; Power BI experience preferredStrong data-driven approach and critical-thinking skills, including identifying trends, evaluating risks, determining root causes, and developing actionable recommendationsAbility to use AI and technology to automate workflows, streamline processes, and improve operational efficiency and effectivenessTravel to WelbeHealth centers as needed to support business-related activities, including occasional overnight staysWe are seeking a highly organized, analytical, and collaborative Senior Quality Operations Specialist, CAP & Monitoring who is passionate about quality, regulatory compliance, and driving meaningful operational improvement. The ideal candidate brings strong project management, critical-thinking, communication, and problem-solving skills, with the ability to manage multiple CAPs, engage cross-functional 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 compliance 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. Compensation Offering $74,612.76—$98,488.84 USD COVID-19 Vaccination PolicyAt 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 click.appcast.io