Contact Center Quality Analyst

Harbor Health•,

About The Position

The Contact Center Quality Analyst (CCQA) is responsible for auditing member and provider interactions across Harbor Health's contact center channels — phone, email, chat, and text — to evaluate adherence to quality standards, operational workflows, and regulatory requirements. This role plays a critical part in protecting member experience, ensuring CMS and HIPAA compliance, and providing actionable feedback that drives continuous improvement across contact center teams.

Requirements

2+ years in a contact center QA role, preferably in a healthcare or managed care environment
Comprehensive knowledge of contact center policies, procedures, and quality scoring frameworks
Solid understanding of HIPAA, CMS, and TDI compliance regulations and ability to apply them in auditing contexts
Strong analytical skills; proficiency with Excel or Tableau for data synthesis and root cause identification
Exceptional written and verbal communication, including clear documentation and professional escalation skills
Meticulous attention to detail; experience maintaining audit trails and quality records
Objectivity and fairness in evaluation; ability to articulate and defend scoring rationale
High learning agility; proven ability to work independently in a fast-paced, ambiguous environment

Nice To Haves

Experience auditing in a payvider, ACO, or value-based care contact center
Familiarity with HEDIS, Star Ratings, or URAC/NCQA accreditation standards
Knowledge of grievance, appeals, and prior authorization workflows
Experience with Athena or similar EHR/CRM platforms
Bilingual: English / Spanish
Coaching and performance management experience

Responsibilities

Conduct routine and targeted audits of contact center interactions to evaluate adherence to quality standards, workflows, and regulatory mandates
Ensure all audited interactions and documentation strictly comply with HIPAA, CMS guidelines, internal policies, and quality documentation standards
Apply standardized, objective evaluation criteria and quality scoring methodologies consistently across all interaction types and market segments
Analyze audit results and interaction data to identify emerging performance trends, recurring compliance risks, and systemic process bottlenecks
Document all audit findings, quality scores, and supporting evidence in the tracking system; maintain audit-ready records for internal and external review
Participate actively in calibration sessions to ensure inter-rater reliability and scoring alignment across all QA teams
Provide timely, constructive, and actionable feedback to support coaching, training, and performance improvement for agents and supervisors
Escalate critical quality or compliance issues, potential breaches, or systemic errors to appropriate leadership following established protocols