Director, Quality Operations – Audit
WelbeHealth
full-time
Posted on:
Location Type: Remote
Location: California • United States
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Salary
💰 $159,939 - $211,119 per year
Job Level
About the role
- 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.
Requirements
- Bachelor’s degree in relevant field; professional experience may be substituted; master’s degree in relevant field preferred
- Five (5) years of experience specifically within Audit, three (3) years must be experience as a Quality/assurance director or manager in a healthcare setting, or directing health or elder care programs with oversight of QI or compliance
- Two (2) years of supervisory experience with demonstrated ability to mentor and develop team members
- Formal Quality Improvement and Analytics Certifications preferred
- Experience in or knowledge of health care compliance, including WelbeHealth-specific program compliance and HIPAA requirements, strongly preferred
- Experience and exceptional capabilities managing data and conducting analyses using productivity suite software including complex spreadsheets and data visualization tools; Excel and PowerBI experience a plus
- Experience as Lean Six Sigma green belt or black belt preferred
Benefits
- 401k + employer match
- Medical insurance coverage (Medical, Dental, Vision) starting day one of employment
- Work life balance – we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, sick time
- And additional benefits
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
data analysisquality improvementcompliance managementprocess improvementaudit managementdata visualizationLean Six Sigmametrics developmentoperational performance analysiscorrective action planning
Soft Skills
collaborationmentoringteam developmentcommunicationleadershiporganizational skillsproblem-solvinganalytical thinkingstrategic planningparticipant satisfaction focus
Certifications
Bachelor's degreeMaster's degreeQuality Improvement CertificationAnalytics CertificationLean Six Sigma Green BeltLean Six Sigma Black Belt