Job summary
Job post source
This job is directly from WellSense Health Plan
Job overview
The Senior Director, Operational Quality & Compliance at WellSense Health Plan leads enterprise-wide quality, compliance, and system implementation initiatives to improve healthcare operations and member/provider experience.
Responsibilities and impact
The role involves strategic leadership in quality and compliance, operational configuration governance, system implementation oversight, process optimization, regulatory documentation, audit support, data-driven performance monitoring, and providing functional leadership without direct line authority.
Compensation and benefits
The position offers competitive salaries, excellent benefits, and full-time remote work options.
Experience and skills
Candidates should have a bachelor's degree or equivalent experience, 10+ years in healthcare operations with expertise in configuration, knowledge of CMS and state regulations, and strong leadership and communication skills; advanced degrees or certifications are preferred.
Work environment and culture
WellSense promotes diversity and inclusion, offers flexible hours, remote work with occasional office travel, and emphasizes collaboration across dispersed teams.
Company information
WellSense Health Plan is a nonprofit regional health insurer with a 25-year history, serving over 740,000 members in Massachusetts and New Hampshire with Medicare, Individual, Family, and Medicaid plans.
Job location and travel
Primarily remote with occasional travel to the office in Massachusetts or New Hampshire.
Unique job features
The role uniquely combines strategic operational quality leadership with deep healthcare configuration expertise and cross-functional influence in a highly regulated environment.
Company overview
WellSense Health Plan is a non-profit managed care organization that provides health insurance plans to individuals and families, primarily through Medicaid and Medicare programs. They generate revenue by receiving payments from state and federal governments to manage healthcare services for their members. Founded in 1997 as Boston Medical Center HealthNet Plan, the company rebranded to WellSense Health Plan to reflect its broader mission of promoting wellness and making sense of healthcare complexities. They are known for their comprehensive coverage, community-focused initiatives, and commitment to improving health outcomes for underserved populations.
How to land this job
Position your resume to highlight your extensive expertise in healthcare operations and configuration, emphasizing leadership in enterprise-wide quality, compliance strategies, and system implementations.
Focus on showcasing your ability to drive operational quality initiatives, manage regulatory compliance, and lead cross-functional collaboration across business, IT, product, and compliance teams.
Apply through multiple channels such as WellSense Health Plan’s corporate careers page and LinkedIn to maximize your application visibility and increase chances of consideration.
Connect with current WellSense employees in operational quality, compliance, or healthcare configuration roles on LinkedIn; use ice breakers like commenting on recent WellSense initiatives, asking about their experience with system implementations, or expressing admiration for their commitment to member-focused health plans.
Optimize your resume for ATS by incorporating keywords from the job description such as 'operational quality,' 'compliance strategies,' 'configuration accuracy,' 'CMS regulatory standards,' and 'system implementations' to ensure it passes automated screenings.
Utilize Jennie Johnson’s Power Apply feature to automate tailored applications, identify multiple application portals, and find relevant LinkedIn contacts to network with, allowing you to focus your energy on interview preparation and strategic job search activities.
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