Quality Compliance & AI Operations Analyst

Vida Health

6d•$80,000 - $90,000•Remote

About The Position

The Quality Compliance and AI Operations Analyst for Vida Member Services is an individual contributor responsible for executing quality assurance initiatives, driving continuous process improvements, and optimizing contact center workflows across omni-channel interactions. The role calls for cross-functional collaboration, project management, and hands-on expertise in healthcare compliance standards, speech analytics, and operational data analysis within a remote healthcare contact center environment. The analyst develops quality programs, monitors and analyzes operational and quality data, and uses automated compliance insights to support staff training and service quality. The position also designs and tunes AI-based quality prompts and rules, manages human review workflows, supports calibration and escalation processes, and leads quality and efficiency improvements across voice, chat, email, and AI-agent channels.

Requirements

Bachelor’s degree in Healthcare Administration, Business, Quality Management, or a related field.
3–5 years of experience in healthcare quality, process improvement, and healthcare technology execution across omni-channel environments, including voice, chat, email, and virtual/AI agents.
Practical experience or strong working knowledge of SQL for querying data and building reports, using tools such as Amazon Athena, Looker, or similar.
Hands-on experience with contact center speech analytics, rule-building, or Auto-QA features, such as AWS Contact Lens, Genesys, or Zendesk.
Strong knowledge of healthcare regulatory requirements, such as HIPAA and CMS, and quality improvement methodologies, including Lean and Six Sigma.
Experience managing Human-in-the-Loop audit workflows, SLA tracking, and QA calibration sessions.
Strong project management skills, including coordinating quarterly initiatives and implementing operational change.
Excellent analytical, root-cause problem-solving, and cross-functional communication skills.
Must be authorized to work in the U.S.; Vida is unable to sponsor work visas.
Must reside in and be able to work from the U.S.; international work is prohibited.
Must be located in or able to work from a state where Vida is registered.

Nice To Haves

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, such as BBB escalations.
Familiarity with BI and observability tools such as Looker or DataDog.

Responsibilities

Develop and oversee quality programs to ensure compliance with applicable regulations, including HIPAA.
Identify and implement training initiatives to improve service center staff performance and quality, informed by 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 using Amazon Connect Contact Lens/Evaluation Features to flag quality, sentiment, and regulatory compliance risks while minimizing AI hallucination rates.
Extract, query, and analyze quality interaction logs using SQL via Amazon Athena to create weekly defect reports, CSAT trend analyses, and performance dashboards.
Oversee Human-in-the-Loop (HITL) QA review workflows, ensure adherence to SLAs such as 24-hour review for Level 1 high-risk incidents, and manage 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 assessments, and root cause analyses to address compliance or quality-related issues.
Lead efficiency and quality initiatives using Lean, Six Sigma, and other methodologies based on quality findings and regulatory compliance reviews across voice, chat, email, and AI-agent channels.
Perform additional responsibilities as needed.