Agent Oversight Analyst

The Agent Oversight Analyst supports the analytical work behind the department's investigation lifecycle — reviewing and prioritizing complaints, tracking cases against service-level expectations, and turning case data into the trends and metrics leadership uses to drive accountability. The ideal candidate thinks in terms of risk, patterns, and root causes, not just checklists.

• Review, evaluate, and log incoming complaints and allegations from carriers, CMS/CTM channels, internal referrals, and sales leadership; classify by type, carrier, and priority.
• Identify duplicate or related cases and elevate high-risk matters to the Manager, Carrier Compliance and Oversight.

• Analyze caseload and case mix to support assignment decisions; monitor case aging and service-level adherence, flagging at-risk cases and root causes to management.

• Build and analyze reports on complaint volume, trends, case aging, and outcomes to surface issues requiring leadership attention or corrective action.
• Maintain dashboards and tracking tools; prepare materials for leadership and carrier discussions.

• Serve as point of contact for carriers, sales leadership, and investigators on case status and documentation.
• Monitor outstanding CAP and agent-response requirements, flagging non-response patterns and escalating unresolved items.

• Gather and organize investigation documentation (lead data, audit findings, enrollment records, call recordings); identify information gaps.
• Support special projects and process improvements, including automation opportunities.

• Critical Thinking & Trend Recognition — spots patterns and risk in case data; knows what to escape.
• Data Integrity & Reporting — keeps records accurate; understands data quality drives good analysis.
• Organizational Effectiveness — manages competing deadlines and SLAs reliably.
• Communication — clear, professional follow-through with internal and external stakeholders.

• High school diploma or equivalent; 1+ year in compliance, QA, operations, insurance, healthcare, or related field.
• Demonstrated ability to analyze data, identify trends, and use sound judgment.
• Strong Excel/Microsoft Office skills; ability to learn new systems quickly.
• Strong written/verbal communication; able to work independently with confidential information.

• Medicare, healthcare, or insurance compliance experience.
• Experience with Jira, Quick Base, Smartsheet, or similar systems.
• Associate's/Bachelor's degree or relevant certification.