Quality Improvement Lead

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

📋 Description

• Act as the primary client contact and manage client email aliases.

• Evaluate escalation patterns to guide process enhancements and bolster client confidence.

• Collaborate with Operations Transformation teams on implementation strategies, remediation efforts, and transitions between carriers.

• Conduct MSAT trend evaluations and carry out quality assurance and escalation assessments.

• Participate in workforce management meetings concerning staffing, service delivery, and operational adjustments.

• Assist Advocate Team in performance management decisions by providing data-driven insights.

• Organize weekly meetings with Member Resolution Supervisors and Quality Coaching teams.

• Share trend analysis and findings during weekly quality meetings.

• Spearhead process enhancement initiatives aimed at improving service quality and operational efficiency.

• Analyze and compile data on member experiences and operational performance.

• Detect emerging issues through operational metrics and execute proactive interventions alongside leadership.

• Create and oversee team and pod performance reports.

• Examine quality issues, risks, and trends in member feedback.

• Formulate and monitor corrective action plans.

• Ensure data accuracy and align reporting efforts with quality team members.

• Investigate best practices and external benchmarks for improvement.

• Assist in audit remediation and compliance-related quality enhancement activities.

• Lead and engage in cross-functional collaborations to elevate quality, safety, and service results.

• Carry out additional responsibilities as assigned.

⛳️ Requirements

• A minimum of 3 years of experience in service quality improvement, healthcare operations, or related domains.

• At least 2 years of experience in generating reports, dashboards, and visualizations focused on performance enhancement.

• A Bachelor's degree is mandatory.

• CPHQ certification or IHI certification is preferred.

• Familiarity with quality improvement frameworks (e.g., Lean, Six Sigma), root cause analysis, and process optimization.

• Proficient in interpreting and utilizing data to spot trends, test hypotheses, and evaluate outcomes.

• Excellent virtual meeting facilitation capabilities.

• Competence in Google Apps and Mac OS for developing tools, reports, and dashboards.

• Prior experience in healthcare settings is essential.

• Knowledge of member experience metrics is advantageous.

• Outstanding organizational and communication abilities.

• Capability to influence stakeholders and foster cross-functional collaboration.

• Self-motivated with a problem-solving attitude and proactive approach.

• Ability to quickly adapt in a dynamic, fast-paced environment while managing multiple priorities.

• Capacity to remain seated for extended periods.

• Good eye-hand coordination and manual dexterity to effectively use a keyboard, computer, and other office equipment.

• Ability to interact appropriately with leadership, employees, and members.

🏝️ Benefits

• Remote-first culture.

• 401(k) savings plan through Fidelity.

• Comprehensive medical, vision, and dental coverage through a variety of medical plan options, including disability insurance.

• Paid Time Off ("PTO") and Discretionary Time Off (“DTO”).

• 12 weeks of 100% paid parental leave.

• Fertility coverage.

• $25,000 available for surrogacy/adoption.

• Paid leave for unsuccessful treatments, adoption, or pregnancies.

• Work-from-home reimbursement to facilitate team collaboration in a home office setting.

• Equity.