Quality Analyst

• Participate in and/or lead calibration sessions with Client partners, Trainers/Subject Matter Experts, Team Leaders and other Quality Analysts to ensure consistency in scoring and feedback delivery
• Generate regular quality performance reports (e.g., daily, weekly, monthly) highlighting key trends, areas of concern, and opportunities for improvement.
• Ensure agent adherence to all company policies, procedures, regulatory guidelines (e.g., CMS regulations for Medicare), and client-specific requirements and escalate potential compliance risks based on audit findings.
• Assess the overall member experience and identify opportunities to improve caller satisfaction.
• Participate in performance review discussions with Operations where quality data is relevant and offer support agent performance improvement initiatives.

Strong Healthcare Background (Non-negotiable):

• In-depth knowledge of

  US healthcare

  ,

  Medicare

  ,

  Medicaid, ACA, and/or private health insurance plans, benefits, and terminology.

• Comprehensive understanding of healthcare regulations including HIPAA, CMS guidelines, and state-specific privacy laws.

Demonstrated Expertise in Quality Assurance:

• Proven experience in conducting comprehensive call/interaction monitoring and audits.
• Strong analytical skills with the ability to interpret complex data, identify trends, and pinpoint root causes of quality issues.
• Proficiency in developing and implementing effective quality improvement plans.
• Experience in generating reports using Excel or other platforms
• Ability to lead and participate in calibration sessions to ensure consistency and objectivity.

⚠️ Disclaimer: