Quality Compliance, AI Operations Analyst

This is a fully remote position, open to applicants in United States.

📋 Description

• Develop and manage quality programs to ensure adherence to relevant regulations, including HIPAA.

• Identify and put into action training initiatives aimed at enhancing service center staff performance and quality by leveraging automated compliance insights and audit trends.

• Monitor and assess KPIs to enhance patient outcomes, operational efficiency, and service quality.

• Design, construct, and optimize AWS Auto-QA prompts and rule-building mechanisms using Amazon Connect Contact Lens/Evaluation Features to identify quality, sentiment, and regulatory compliance risks while reducing AI hallucination rates.

• Extract, query, and evaluate quality interaction logs using SQL via Amazon Athena to produce weekly defect reports, CSAT trend analyses, and performance dashboards.

• Supervise Human-in-the-Loop QA review workflows, ensuring adherence to SLAs and managing the QA appeals process.

• Conduct QA calibration sessions with leadership and Quality Analysts.

• Manage cross-functional escalation pathways for privacy and security incidents, member complaints, and partner coaching escalations.

• Execute audits, risk assessments, and root-cause analyses to resolve compliance and quality challenges.

• Spearhead efficiency and quality initiatives using Lean, Six Sigma, and other methodologies across voice, chat, email, and AI-agent channels.

• Undertake additional responsibilities as required.

⛳️ Requirements

• Bachelor’s degree in Healthcare Administration, Business, Quality Management, or a related discipline.

• A minimum of 3-5 years of experience in healthcare quality, process improvement, and healthcare technology execution across omni-channel environments (voice, chat, email, and virtual/AI agents).

• Practical experience or a solid working knowledge of SQL for data querying and report generation (e.g., via Amazon Athena, Looker, or similar platforms).

• Hands-on experience with contact center speech analytics, rule-building, or Auto-QA functionalities (e.g., AWS Contact Lens, Genesys, or Zendesk).

• Comprehensive understanding of healthcare regulatory requirements (e.g., HIPAA, CMS) and quality improvement methodologies (Lean, Six Sigma).

• Experience in managing Human-in-the-Loop (HITL) audit workflows, SLA tracking, and QA calibration sessions.

• Strong project management capabilities with a track record of coordinating quarterly initiatives and executing operational changes.

• Exceptional analytical, root-cause problem-solving, and cross-functional communication skills.

• Lean Six Sigma certification (Yellow Belt or Green Belt) is preferred.

• Familiarity with AI/LLM evaluation techniques or prompt tuning in a contact center context is preferred.

• Experience with privacy breach escalation protocols and formal complaint resolution processes (e.g., BBB escalations) is preferred.

• Familiarity with BI and observability tools such as Looker or DataDog is preferred.

• Must be authorized to work in the U.S.; Vida cannot sponsor work visas.

• Must reside in or be capable of working from the U.S.; international work is prohibited.

• Must be located in or able to work from a state where Vida is registered.

🏝️ Benefits

• Comprehensive health and wellness benefits.

• Opportunities for professional development and growth.

• Flexible working hours and remote work options.

• Supportive and inclusive company culture.