Quality Compliance & AI Operations Analyst

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. ### 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.