WelbeHealth

People Operations

• Work to foster a cohesive, caring experience for WelbeHealth team members experiencing a need for leave of absence.
• Act as a primary point of contact between the company and the leave/accommodation and workers compensation program.
• Manage the ADA accommodations and workers compensation processes and case management.
• Work closely with Leave Specialist(s) and third-party administrator for leave administration.
• Manage and administer all aspects of employee leave programs such as FMLA, parental, medical, and personal leaves.
• Generate reports and maintain accurate leave records for payroll, benefits continuation, and compliance purposes.
• Provide guidance with empathy and ensure employees understand their options and feel supported throughout their leave.
• Ensure compliance with federal, state, and local leave regulations, including FMLA, ADA, and other applicable laws.

People Specialist – Leaves

Analyst

• Work independently to research, define, plan, and implement new EMR technology projects following the guidance and prioritization of the VP, IT Applications
• Ensure EMR and integrated applications align with business requirements and systems goals, meet end-user needs, and identify and solve systems problems
• Manage EMR application product updates, feature customization and improvement, maintenance, support (service desk tickets), troubleshooting, and customer service
• Lead configuration, planning, and execution of WelbeHealth’s EMR and related applications needs for new market entry (launch)
• Collaborate with the Training team to ensure new technologies, changes, and updates are included in training materials and curricula
• Perform workflow assessments, design workflows to match business requirements, provide additional training and demos, and provide remote support on core technologies when needed
• Evaluate existing EMR and EMR-related technologies used in operations and identify opportunities for increasing value creation and developing process improvement plans accordingly

Senior Applications Analyst

Executive Assistant

• Provide executive-level administrative support to the Executive Team including:
• Drafting written communication as requested
• Handling travel and expenses
• Coordinating schedules
• Taking and maintaining meeting minutes
• Planning and coordinating logistics related to on-site tours and events
• Communicate with external stakeholders on behalf of the leadership team which could include vendors, elected officials, regulators, board members, quality improvement
• Greet and interact with community partners and visitors in a warm and courteous manner, creating a welcoming environment
• Protect privacy and maintain confidentiality of all company procedures and information about team members, participants, and families
• Complete all required documentation in a timely and accurate manner
• Follow WelbeHealth policies and procedures and participate in any required Quality Improvement activities, staff training and meetings

Manager

• Lead our Eligibility team to ensure our participants maintain eligibility for PACE services through proactive management including but not limited to establishing strategies, tools and management processes that prevent eligibility discrepancies
• Leverage advanced data analytics and a deep understanding of regulatory requirements, to proactively identify and mitigate risks pertaining to participant eligibility; ensure reporting accuracy by supervising the verification of eligibility data in key reports, such as encounter and prescription drug event reporting
• Oversee participant demographic, eligibility and enrollment data integrity across Welbe systems
• Monitor revenue impact by directing the analysis of eligibility data, identifying potential financial risks, and ensuring that these risks and outcomes are communicated to finance teams and local programs
• Effectively communicate risks and outcomes to key stakeholders while engaging in a collaborative process that transforms complex data into actionable insights that result in timely decision-making
• Coordinate with local market leaders by directing efforts to identify and prioritize high impact discrepancies, ensuring the team executes corrective actions efficiently and effectively
• Liaise with county and state agencies and other governmental agencies to verify continuous eligibility for Welbe participants and ensuring participants’ Medicaid and Medicare coverage is correctly attributed.

Manager, Eligibility

Operations

• Collaborate with VP, Quality Operations to develop and standardize enterprise metrics in clinical excellence, quality, and patient safety in alignment with all policies and procedures, as well as local, state, federal and CDC guidelines
• Partner with Analytics and Operations Support and Strategy teams to analyze and review operational performance for continuous process improvements, increased efficiency, and greater participant satisfaction
• Monitor and analyze data including plan metrics, HPMS entries, company and market initiatives, and corrective action plans to identify trends and areas for process improvement
• Collaborate with WelbeHealth’s Compliance team on initiatives to monitor and improve compliance issues, corrective action plans, and the Fraud, Waste, and Abuse program
• Ensure complete and timely submission of all information required by regulatory agencies including but not limited to HPMS quality reporting, CMS Quarterly calls, enrollment denials, and audit requirements
• Ensure successful implementation and follow up for all Program Committees, including but not limited to the Quality Improvement Committee and Participant Advisory Committee
• Frequent travel to our WelbeHealth centers will be required based on business needs.

Director, Quality Operations – Audit

Engineering Manager

• Lead end-to-end architecture, development, and delivery of APIs, microservices, and integration pipelines for internal and external healthcare systems, as well as act as the senior-most engineer for the team: designing components, writing high-quality code, troubleshooting complex issues, and performing rigorous code reviews
• Build scalable, cloud-native solutions using Azure, containerized workloads (Docker/Kubernetes), and modern integration frameworks
• Implement repeatable MLOps patterns for model deployment, monitoring, and lifecycle management
• Build prototype PoCs that validate new technologies, workflows, or AI-enabled automations before scaling to production
• Lead and mentor a team of engineers, fostering a culture of innovation, ownership, and continuous learning, as well as step in as the escalation point for technical blockers, guiding the team toward solutions
• Collaborate with Product, Architecture, Cloud, Security, and other engineering teams to define integration strategies and solution blueprints, as well as translate complex technical designs into clear communication for non-technical stakeholders
• Ensure all development aligns with HIPAA, PHI/PII-safe engineering, and healthcare interoperability requirements, as well as apply FHIR, HL7, EDI, and related healthcare interoperability patterns where applicable

Product Adoption Specialist

• Own the development and maintenance of standardized role-specific resources including, but not limited to: SharePoint Role Landing Pages, onboarding guides, role handbooks, skills lists
• Deliver engaging and inspiring training, both virtually and in person, to licensed and unlicensed WelbeHealth staff
• Oversee Relias training plans to ensure relevant content and timely completion
• Develop and maintain skills competency checklist and relevant preceptor guides to align with regulations and best practices
• Draft 30-60-90-day skills lists and evaluation criteria for assigned roles
• Engage and oversee the role’s Teams Channel of SMEs and Preceptors
• Drive workflow compliance for assigned roles, monitor adherence, and advocate for process improvement when indicated
• Collaborate with center hiring managers, preceptors, and launch leaders to identify and address training opportunities
• Act as a key resource for new hires throughout the onboarding process
• Monitor the effectiveness of role-specific training, onboarding, and education materials, adapting to continuously improve
• Act as a central role ambassador and SME for organizational initiatives pertaining to their assigned role

Training & Adoption Specialist

• Collaborate with the QOD on the development of Quality Improvement (QI) Program initiatives and priorities
• Serve as a primary resource for QO Coordinators to ensure accurate application of quality policies and procedures
• Coordinate messaging for the QO team, including maintenance of email inboxes and other communication platforms
• Collect, analyze, and generate reports for regulatory QO department data including that specified in the QI plan, HPMS, and required by state and federal regulations
• Assist with auditing and ensuring timely completion of all regulatory requirements
• Gather universe data elements for PACE and mock audits, and support data requests during audits
• Complete investigations and notifications, along with the grievances, appeals, and HPMS processes as needed

Quality Operations Specialist

Vice President

• Serve as the lead and most fact-based voice on how participants, team members, and meaningful stakeholders experience the WelbeHealth product, as well as report on what’s going well, identify key areas for improvement, and map these insights against highest priority strategic and operational goals
• Own the process for prioritizing areas for transformational product improvement, ensuring strong alignment among leadership
• Design and own the product transformation business case process to ensure that highest priority initiatives are selected with clear KPI deliverables, budgets, resource allocation, and timelines
• Act as the lead designer of transformation initiatives, owning the conceptual stages of design and participating in the more detailed and technical phases within a highly matrixed environment (e.g., generating agile process stories, elaborating requirements, developing clinical informatics informed end-user workflows)
• Maintain programmatic ownership and status reporting of transformation initiatives through implementation and beyond, while collaborating with other reporting lines accountable for technical product management, project management, implementation, training, measurement, etc.
• Own the assessment of impact following launch, providing clear reporting back to relevant stakeholders on the degree of success relative to the approved business case
• Function as the WelbeHealth Product "Chief Communications Officer," maintaining always ready and concise communication regarding product priorities, roadmaps, and risks/mitigations suitable for the board, executive team, all hands meetings, and approved external audiences

VP, Product Transformation

• Develop and implement an effective federal engagement strategy that results in outstanding relationships with regulators and elected officials
• Direct government affairs advocacy efforts to facilitate timely approvals of PACE applications, resolve regulatory issues for operating PACE programs, and influence policy changes that support the WelbeHealth mission
• Establish a proactive strategy to maintain a high level of situational awareness on policy matters, identifying risks and opportunities for WelbeHealth
• Maintain positive relationships with key external stakeholders including trade associations, other healthcare entities, PACE organizations, workgroups, advocacy groups, relevant consumer groups, etc.
• Identify, manage, and effectively leverage WelbeHealth lobbyists, consultants, or other resources to achieve WelbeHealth’s advocacy goals
• Effectively track, synthesize, and communicate relevant government policy changes (laws, regulations, guidance) impacting WelbeHealth
• Represent and engage effectively on behalf of WelbeHealth in relevant associations, inclusive of board and board committee memberships, as well as collaborate with cross-functional departments such as Growth, Strategy, Business Development, Compliance, Marketing, Community Partnerships, Health Plan Operations, and Program Operations

VP, Federal Government Affairs

Auditor

• Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants
• Conduct pre-visit chart preparations and post-visit chart reviews
• Oversee audits and participate in provider education programs to ensure compliance with CMS risk adjustments diagnosis coding guidelines
• Work closely with Coding Supervisor in identifying opportunities for HCC coding education

Coding Auditor, Educator

Claims Specialist

• Assess appropriateness of returned, denied, or paid claims by reviewing and following contractual obligations, federal and state regulations, organizational policies and procedures, or other established quality standards
• Work alongside manager to establish and maintain claims processing rules that meet all regulatory and business requirements
• Assist internal and external partners with questions related to claims decisions or claims statuses