Quality Assurance Analyst (Healthcare)

TL;DR

Quality Assurance Analyst (Healthcare): Monitoring and evaluating customer care interactions to ensure compliance with regulatory standards and service quality with an accent on PBM and healthcare operations. Focus on developing quality scorecards, analyzing performance trends, and supporting continuous improvement initiatives within a fast-paced startup environment.

Location: Remote (US)

Salary: $71,200 – $112,000 USD

Company

hirify.global is an enterprise health technology company providing comprehensive pharmacy benefit management and health benefit administration solutions to improve healthcare trust and infrastructure in the U.S.

What you will do

• Develop and maintain customer care quality scorecards to evaluate agent performance against departmental standards.
• Conduct quality evaluations of recorded and live interactions to ensure consistency and adherence to guidelines.
• Facilitate calibration sessions with internal teams, partners, and clients to align on scoring and service quality.
• Analyze QA data to identify trends, uncover improvement opportunities, and provide actionable insights to leadership.
• Oversee the end-to-end processing of member complaints and grievances in compliance with regulatory and internal standards.
• Provide operational support by handling inbound or outbound calls as needed to meet business demands.

Requirements

• 4+ years of experience in call center operations, with at least 2 years in Quality Assurance or training.
• Knowledge of HIPAA, Privacy Rule regulations, and Medicare.
• Strong analytical and organizational skills with the ability to work with little or no supervision.
• Aptitude for developing processes and coaching frontline customer service employees.
• Ability to give and receive constructive feedback in a fast-paced environment.
• Must be based in the United States.

Nice to have

• Experience in PBM or Healthcare call center operations.
• Bachelor’s degree.

Culture & Benefits

• Opportunity to work in a fast-growing, mission-driven startup environment.
• Focus on rebuilding trust in the U.S. healthcare system.
• Commitment to diversity, equity, and inclusion.
• Flexible role design allowing for management to reassign duties to meet organizational goals.