Quality Improvement Director

WelbeHealth is a public benefit company founded in 2015 that offers comprehensive medical and social care to socioeconomically disadvantaged seniors in a way that allows them to continue living in the community, as opposed to going into a nursing home. We do this through the Program of All-Inclusive Care for the Elderly (PACE).

Under the direction of the Executive Director and in close collaboration with the Medical Director, the Quality Improvement (QI) Director develops and implements an effective and robust PACE quality program that ensures WelbeHealth participants are uniquely cared for. As a compliance leader and driver of care excellence, the QI Director oversees QI activities, guides the QI team, and effectively communicates quality results to participants, team members, the board and its committees, and regulatory agencies.

Essential Job Duties:

• Partner with all WelbeHealth market QI Directors to monitor and standardize the QI program for WelbeHealth PACE programs across the enterprise
• Collaborate with the Medical Directors and QI team members on the development and implementation of QI program initiatives, and leverage best practices among WelbeHealth PACE programs
• Collaborate with our CMO and Medical Directors 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
• Collaborate with WelbeHealth’s Compliance team to monitor and improve compliance issues, corrective action plans, and the Fraud, Waste, and Abuse program
• Collaborate with Executive Director and Medical Director during PACE Program's Federal and State audits from facility review through corrective action plan development and monitoring
• Oversee the grievance and appeal process, including the delegation of investigating all quality reviews for potential quality of care concerns, as well as quality of service and access issues, including collection and evaluation of appropriate data
• Support PACE program procedures to process grievances and complaints in accordance with applicable state and federal regulations, compliance standards, and policies and procedures
• Develop and maintain relationships with state and federal regulatory agencies, including the NY Department of Health Care Services and Centers for Medicare and Medicaid Services

Job Requirements:

• Bachelor’s degree required, master’s degree in relevant field preferred
• Experience as Lean Six Sigma green belt or black belt preferred
• Formal Quality Improvement and Analytics Certifications preferred
• Minimum of five (5) years of experience as a QI/Assurance Director or Manager in a healthcare setting, or managing health/eldercare programs with oversight of QI or compliance
• Two (2) years of supervisory experience with demonstrated ability to mentor and develop team members

Benefits of Working at WelbeHealth: Apply your quality improvement expertise in new ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.

• Medical insurance coverage (Medical, Dental, Vision)
• Work/life balance – we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, sick time
• Advancement opportunities - We’ve got a track record of hiring and promoting from within, meaning you can create your own path!
• And additional benefits