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Director, Quality Operations
WelbeHealth. Develop and implement an effective and robust PACE quality program .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in developing and implementing quality improvement programs in healthcare settings, with a strong focus on regulatory compliance, data analysis, and team leadership. Proven ability to enhance operational efficiency and patient safety through effective quality strategies and metrics.
Highest-signal resume keywords
Quality Improvement Program DevelopmentRegulatory Compliance and AuditsData Analysis and VisualizationTeam Leadership and MentoringLean Six Sigma Certification
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Quality Improvement PlansOperational Performance AnalysisData ManagementProcess Improvement InitiativesStandardized Workflows Development
Soft Skills
CommunicationCollaborationMentoring
Tools & Technologies
ExcelPowerBIProductivity Suite Software
Certifications & Qualifications
Lean Six Sigma Green BeltLean Six Sigma Black BeltQuality Improvement Certifications
Industry Keywords
PACE RegulationsCalifornia DHCSHealthcare Quality AssuranceCompliance ExcellenceFraud, Waste, and Abuse Program
About the role
Key responsibilities & impact- Develop and implement an effective and robust PACE quality program
- Oversee Quality Operations activities and lead Quality Operations teams
- Communicate quality results to team members, the board and its committees, and regulatory agencies
- Identify education and training opportunities to improve team member performance
- Lead enterprise-wide quality strategy and compliance excellence
- Design, implement, and continuously improve the PACE quality program
- Collaborate with Analytics, Compliance, and Operations teams to translate complex data into actionable insights
- Develop and standardize enterprise metrics in clinical excellence, quality, and patient safety
- Develop standardized quality operations workflows, playbooks, tools, and resources
- Implement scalable approaches to collecting and analyzing data and generating visualizations and reports
- Analyze operational performance for continuous process improvements, increased efficiency, and participant satisfaction
- Monitor QI plan metrics, HPMS entries, company and market initiatives, and corrective action plans to identify trends and improvement areas
- Serve as a QI subject matter expert on program and company initiatives
- Collaborate on compliance issues, corrective action plans, and the Fraud, Waste, and Abuse program
- Ensure PACE program complaints are investigated, responded to, and documented
- Support grievance and complaint procedures in accordance with applicable regulations and standards
- Submit required information to regulatory agencies, including HPMS quality reporting, CMS Quarterly calls, enrollment denials, and audit requirements
Requirements
What you’ll need- Candidates must reside in California, preferably in Northern California, or within a 2-hour direct flight of Sacramento, with the ability to travel onsite as needed for business and regulatory requirements
- Bachelor’s degree in relevant field; professional experience may be substituted
- Five (5) years of experience required, three (3) years of which must be as a QI/assurance Director/Manager in a healthcare setting, or in managing health/elder care programs with oversight of QI or compliance
- Three (3) years of supervisory experience with demonstrated ability to mentor and develop team members
- Hands-on experience working with the California DHCS and navigating state-level regulatory expectations
- Experience with regulatory compliance and audits required, including preparing for and responding to CMS, DHCS, and other state/federal regulatory reviews
- Demonstrated experience developing, implementing, and managing QI plans in alignment with regulatory requirements
- Experience managing data and conducting analyses using productivity suite software, complex spreadsheets, and data visualization tools
- Experience developing, managing, and monitoring CAPs to address compliance and quality issues
- Proven ability to lead process improvement initiatives, identify gaps, and implement sustainable operational enhancements
- Experience as Lean Six Sigma green belt or black belt preferred
- Formal QI and analytics certifications preferred
- Master’s degree in relevant field preferred
- Experience working with and implementing PACE regulations preferred
- Excel and PowerBI experience a plus
- Proof of vaccination or a vaccine declination form required prior to employment
Benefits
Comp & perks- Medical insurance coverage (Medical, Dental, Vision)
- 17 days of personal time off (PTO)
- 12 holidays observed annually
- 6 sick days
- 401K savings + match
- Bonus
- Comprehensive healthcare coverage
- Additional benefits
- Vaccination policy and infection control/PPE standards