Senior Regional Quality Operations Specialist

Senior Regional Quality Operations Specialist

Stockton, CA, USA

Must be residing in ideally the Central Valley/ Stockton, CA as this role will require frequent travel to Stockton, Modesto and Elk Grove based on business needs. HYBRID ROLE

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.

Under the direct supervision of the Quality Operations Directors (QODs) and in close collaboration with the Vice President of Quality Operations, the Senior Regional Quality Operations Specialist plays a key role in driving regulatory compliance and continuous quality improvement across the organization. This role ensures effective management and follow-through of quality initiatives stemming from internal and external audits, complaint investigations, and performance assessments. The Senior Regional Quality Operations Specialist leads the coordination and implementation of corrective action plans (CAPs) and preventive measures, facilitates comprehensive root cause analyses (RCA) with cross-functional partners, and supports the design, execution, and evaluation of targeted quality improvement strategies. This role also ensures accurate and consistent collection and reporting of enterprise trends and analysis of CAP outcomes, progress of interventions, and risk assessment.

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

• Plays a critical role in strengthening regulatory compliance and quality performance across markets, directly impacting participant safety and care outcomes in a highly regulated PACE environment
• Leads complex, cross-functional quality initiatives, driving sustainable process improvements across clinical and operational teams

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:

• Partner with QODs and market leadership to implement quality activities, ensuring compliance with federal, state, and contractual regulatory requirements
• Collaborate with QODs, Executive Directors (EDs), and Medical Directors (MDs) to address regulatory findings and compliance issues at the market level
• Lead and facilitate RCAs with required stakeholders to identify systemic issues and prevent recurrence
• Support regulatory process improvement by ensuring that RCA outcomes are translated into actionable and measurable CAPs
• Assist QODs in the development and implementation of CAPs following audit findings, complaints, or regulatory observations
• Track, monitor, and validate the progress of CAPs to ensure timely completion and measurable improvement in compliance performance, as well as prepare summary reports for leadership review
• Partner with QODs to evaluate the effectiveness of CAPs and ensure sustainability of improvements

Job requirements include:

• Must be residing in the State of CA (ideally in the Central Valley/ Stockton, CA) as this role may require frequent travel to Stockton, Modesto and Elk Grove based on business needs.
• Bachelor's degree in relevant field required; master's degree preferred
• Minimum of three (3) years of experience in quality improvement/assurance in a healthcare setting, or in health or eldercare programs with oversight of quality/compliance
• Previous experience with process improvement, risk assessment, and quality improvement methodologies (e.g., PDSA, Lean, Six Sigma)
• Experience in or knowledge of healthcare compliance, PACE-specific program compliance, and HIPAA requirements required
• Experience working with multidisciplinary teams required
• Experience with managing data and conducting analyses using software including but not limited to productivity suite software, Smartsheet, and Power BI
• Experience with electronic medical records, preferably Athena

We are seeking a Senior Regional Quality Operations Specialist with experience in healthcare quality, compliance, and regulatory oversight (ideally within PACE, Medicare, or Medicaid environments), who can lead root cause analyses, drive corrective action plans, and partner across multidisciplinary teams to improve quality outcomes. If you're passionate about continuous improvement and making a meaningful impact on participant care, 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.

$82,074.03 - $108,337.72 USD

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.

Beware of Scams

Please 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 fraud.report@welbehealth.com