Operations

• Partner with QOD and market leadership to implement WelbeHealth’s Quality Improvement (QI) program and on market-level process improvement initiatives
• Onboard and mentor new quality specialist team members
• Support regulatory process improvement, such as leading RCAs
• Conduct additional market-level audits as assigned, as well as review and analyze reports of market-level data including that specified in the QI plan and required by state and federal regulations
• Highlight data trends to the QOD, EDs, or market leaders for process improvement opportunities, as well as provide support through the preparation and successful completion of all state, federal, and mock audits
• Assist the QOD in monitoring corrective action plans, and in overseeing the preparation, implementation, and follow-up of all QI Program Committees, including the Quality Improvement Committee and Participant Advisory Committee
• Organize and gather information for monthly and quarterly CMS meetings with the QOD, ED, Medical Director and other key stakeholders, and act as the liaison to notify regulators of IDT updates such as prospective denial enrollees and involuntary disenrollment requests

Regional Quality Operations Specialist

Radar Operations Engineer

Supplier Quality Engineer – Industrialization

Supplier Quality Operations Engineer

Senior Manager, Operations – Connectivity Solutions

Supervisor, Mid Revenue Cycle – Integrity Operations Coding Denials