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Contact Center Quality Analyst

Harbor Health Services

Contact Center Quality Analyst

Harbor Health is seeking a Contact Center Quality Analyst to audit member and provider interactions across our contact center channels — phone, email, chat, and text — evaluating adherence to quality standards, operational workflows, and regulatory requirements. This role plays a critical part in protecting the member experience, ensuring CMS and HIPAA compliance, and delivering actionable feedback that drives continuous improvement across our contact center teams. You will work collaboratively across QA, compliance, clinical, and operations to uphold the standards that define how we serve our members — in alignment with our mission of transforming healthcare through our payvider model.

POSITION DUTIES & 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

DESIRED PROFESSIONAL SKILLS & EXPERIENCE

Required:

  • 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 skills, including clear documentation and professional escalation practices
  • Meticulous attention to detail with experience maintaining audit trails and quality records
  • Objectivity and fairness in evaluation; ability to articulate and defend scoring rationale
  • High learning agility and proven ability to work independently in a fast-paced, ambiguous environment

Preferred:

  • 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 in English/Spanish
  • Coaching and performance management experience

WHAT WE OFFER

  • Competitive salary and incentives
  • Generous PTO
  • 10 paid holidays
  • Medical, Dental, and Vision Insurance
  • 401(k) Investment Plan
  • Company Equity
  • Professional development and growth opportunities as Harbor Health scales its operations

At Harbor Health, we're transforming healthcare in Texas through collaboration and innovation. We're seeking passionate individuals to help us create a member-centered experience that connects comprehensive care with a modern payment model. If you're ready to make a meaningful impact in a dynamic environment where your contributions are valued, please bring your talents to our team!

Vacancy posted 2 days ago
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