Note: The job is a remote job and is open to candidates in USA. Vida Health is hiring a Quality Compliance & AI Operations Analyst for its Member Services team. The role executes quality assurance and compliance initiatives, improves contact center workflows, and uses AI tools and operational data to enhance service quality across channels.
Responsibilities
- Develop and oversee quality programs to ensure compliance with all applicable regulations (e.g., HIPAA)
- Identify and implement training initiatives to enhance service center staff performance and quality based on automated compliance insights and audit trends
- Track and analyze KPIs to improve patient outcomes, operational efficiency, and service quality
- Design, build, and continuously tune AWS Auto-QA prompts and rule-building mechanisms (Amazon Connect Contact Lens/Evaluation Features) to flag quality, sentiment, and regulatory compliance risks while actively minimizing AI hallucination rates
- Extract, query, and analyze quality interaction logs using SQL via Amazon Athena to build weekly defect reports, CSAT trend analyses, and performance dashboards
- Oversee Human-in-the-Loop (HITL) QA review workflows, ensuring strict adherence to SLAs (e.g., 24-hour review for Level 1 high-risk incidents) and managing the QA appeals process
- Facilitate regular QA calibration sessions with leadership and Quality Analysts to maintain scoring consistency across manual and automated evaluations
- Oversee cross-functional escalation pathways, including potential privacy and security incidents, member complaints to third party agencies, and internal partner coaching escalations
- Conduct audits, risk assessment, and root cause analyses to address compliance or quality-related issues
- Lead efficiency and high quality initiatives using Lean, Six Sigma and other methodologies based on quality findings, and regulatory compliance review across all channels of communication such as voice, chat, email and AI agents
- Additional responsibilities as needed
Skills
- Bachelor's degree in Healthcare Administration, Business, Quality Management, or a related field
- Minimum 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 strong working knowledge using SQL to query data and build reports (e.g., via Amazon Athena, Looker, or similar tools)
- Hands-on experience with contact center speech analytics, rule-building, or Auto-QA features (e.g., AWS Contact Lens, Genesys, or Zendesk)
- Strong knowledge of healthcare regulatory requirements (e.g., HIPAA, CMS) and quality improvement methodologies (Lean, Six Sigma)
- Experience managing Human-in-the-Loop (HITL) audit workflows, SLA tracking, and QA calibration sessions
- Strong project management skills with experience coordinating quarterly initiatives and implementing operational change
- Excellent analytical, root-cause problem-solving, and cross-functional communication skills
- Applicants must be authorized to work in the U.S. as Vida is unable to sponsor work visas for any position
- All Vida Employees must reside in/be able to work from the U.S.- international work is prohibited
- Lean Six Sigma certification (Yellow Belt or Green Belt)
- Familiarity with AI/LLM evaluation techniques or prompt tuning in a contact center setting
- Experience with privacy breach escalation protocols and formal complaint resolution processes (e.g., BBB escalations)
- Familiarity with BI and observability tools such as Looker or DataDog
Benefits
- Remote work; employees must reside in or be able to work from the U.S., and only states where Vida is registered are eligible.
Company Overview