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Quality Compliance & AI Operations Analyst

🕒 12 days ago
Healthcare Quality AssuranceHIPAACMSSQL
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📜 Description

  • Develop quality programs and audits to support compliance with regulations such as HIPAA.
  • Use automated compliance insights and audit trends to guide staff training and service improvements.
  • Track KPIs and analyze interaction data to improve patient outcomes, operational efficiency, and service quality.
  • Build and tune AWS Auto-QA prompts and rules to flag quality, sentiment, and compliance risks while minimizing AI hallucinations.
  • Query quality logs with SQL in Amazon Athena and create defect reports, CSAT analyses, and performance dashboards.
  • Manage HITL QA reviews, SLAs, appeals, calibration sessions, escalations, and root-cause improvement initiatives across voice, chat, email, and AI agents.

🛠️ Requirements

  • 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.
  • Lean Six Sigma certification (Yellow Belt or Green Belt).
  • Familiarity with AI/LLM evaluation techniques or prompt tuning in a contact center setting.
Full job description
ABOUT US
At Vida, we help people get better- and we're helping the healthcare system get better, too.
Vida is a virtual, personalized obesity care provider that uses evidence-based treatment to help patients manage obesity and related conditions like diabetes, high blood pressure, anxiety and depression. Vida's team of Obesity Medicine-Certified Physicians, Registered Dietitians, Expert Coaches and Licensed Therapists takes a whole-person approach to care, helping people lose weight, reduce stress and improve their overall health.
By combining advanced technology with top-notch healthcare providers, Vida is breaking down the barriers that have historically kept people from getting the best care. It's trusted by Fortune 100 companies, major national payers and large providers to enable their employees to live their healthiest lives.

The Quality Compliance and AI Operations Analyst for Vida Member Services is responsible for executing quality assurance initiatives, driving continuous process improvements, and optimizing contact center workflows across omni-channel interactions. This individual contributor role requires strong cross-functional collaboration, project management skills, and hands-on expertise in healthcare compliance standards, speech analytics, and operational data analysis within a remote healthcare contact center environment.
ABOUT US   At Vida, we help people get better- and we're helping the healthcare system get better, too.   Vida is a virtual, personalized obesity care provider that uses evidence-based treatment to help patients manage obesity and related conditions like diabetes, high blood pressure, anxiety and depression. Vida's team of Obesity Medicine-Certified Physicians, Registered Dietitians, Expert Coaches and Licensed Therapists takes a whole-person approach to care, helping people lose weight, reduce stress and improve their overall health.   By combining advanced technology with top-notch healthcare providers, Vida is breaking down the barriers that have historically kept people from getting the best care. It's trusted by Fortune 100 companies, major national payers and large providers to enable their employees to live their healthiest lives. Vida is proud to be an Equal Employment Opportunity and Affirmative Action employer.   Diversity is more than a commitment at Vida—it is the foundation of what we do. All qualified applicants will receive consideration for employment without regard to race, color, ancestry, religion, gender, gender identity or expression, sexual orientation, marital status, national origin, genetics, disability, age, or Veteran status. We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law.   We seek to recruit, develop and retain the most talented people from a diverse candidate pool. We don’t just accept differences — we celebrate them, we support them, and we thrive on them for the benefit of our employees, our platform and those we serve. Vida is committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans in our job application procedures.   We do not accept unsolicited assistance from any headhunters or recruitment firms for any of our job openings. All resumes or profiles submitted by search firms to any employee at Vida in any form without a valid, signed search agreement in place for the specific position will be deemed the sole property of Vida. No fee will be paid in the event the candidate is hired by Vida as a result of the unsolicited referral.   **Vida is authorized to do business in many, but not all, states. If you are not located in or able to work from a state where Vida is registered, you will not be eligible for employment. Please speak with your recruiter to learn more about where Vida is registered.   Please note: 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. Job postings at Vida will remain open through end of year, until filled.   #LI-remote

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.
  • Qualifications:

  • 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.
  • Preferred:

  • 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.
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