Operations QA Analyst

• Collect and analyze data from Operations Quality Assurance Associate evaluations
• Identify trends, insights, risks, and opportunities in program and agent performance
• Create slide decks and present findings to internal and external stakeholders and clients
• Recommend process improvements and lead teams toward action-oriented results
• Lead meetings with Operations leadership and clients about program quality scores and opportunities
• Communicate trends and quality risks and monitor improvement opportunities
• Provide structured coaching feedback to Operations Leadership and Operations Agents
• Coach Operations Quality Associates through peer-to-peer coaching
• Train new department hires and operations agents on business rules and processes
• Complete evaluations of Operations Agents’ work for adherence to business rules, SOPs, WINs, and compliance standards
• Recommend and lead process improvement projects and cross-functional quality initiatives

• Associate Degree or four years of experience required
• Two to four years of process improvement experience, including training in statistical tools/reporting and preferably Six Sigma techniques
• Two to four years in a quality assurance or quality auditing role, preferably in a call center, claim operations, pharmacy hub, or similar environment
• Healthcare experience—specifically claim processing, contact center, benefit verification, case management, or similar industry experience—is required
• Quality certification such as Lean Six Sigma Yellow or Green Belt is a plus
• Prefer Lean Six Sigma certification at Yellow Belt level or higher
• Strong understanding of Microsoft Office products (Excel, Word, PowerPoint, etc.)
• Excellent verbal and written communication skills
• Bilingual English/Spanish is a plus
• Must be able to operate standard office and computer equipment
• Must adhere to company policies, procedures, training, and applicable compliance requirements, including SOC1, SOC2, PCI, and HIPAA

Demonstrates expertise in data analysis, process improvement, and quality assurance within healthcare environments, with a strong focus on training and coaching operations teams. Proficient in utilizing statistical tools and methodologies to drive actionable insights and enhance program performance.

• Process Improvement Experience
• Quality Assurance Expertise
• Lean Six Sigma Certification
• Data Analysis Skills
• Bilingual English/Spanish

• Data Analysis
• Process Improvement
• Quality Assurance
• Statistical Tools
• Training and Coaching
• Compliance Standards
• Evaluations
• SOP Adherence
• Trend Identification
• Risk Assessment

• Verbal Communication
• Written Communication
• Team Leadership
• Coaching
• Presentation Skills

• Lean Six Sigma Yellow Belt
• Lean Six Sigma Green Belt

• Healthcare
• Claim Processing
• Contact Center
• Benefit Verification
• Case Management
• Quality Auditing
Operations Quality Assurance???