Quality Improvement Lead

Job description

Job Summary: The Quality Improvement Lead (QIL) plays a critical role in transforming data into actionable insights to enhance the member experience, quality of care, and service excellence. This role helps leaders understand member feedback, assess operational performance, and identify opportunities for scalable improvements. The ideal candidate is passionate about service and care excellence and demonstrates strong analytical skills with an ability to translate data into meaningful improvements. They thrive in a fast-paced environment, take ownership of their work, and collaborate effectively with leadership to drive data-informed decision-making. Responsibilities: Client Engagement & Service Insights: • Interact with and serve as a point of contact for clients, ensuring clear communication and responsiveness to needs. • Manage and respond to client email aliases, ensuring timely and professional communication. • Proactively analyze and identify escalation trends to inform process improvements and enhance client confidence. • Partner with Operations Transformation teams on implementation planning, remediations, and carrier transitions to ensure seamless service. Member Experience & Performance Improvement: • Conduct MSAT (Member Satisfaction) trend analysis, ensuring insights drive action and accountability. • Perform QA and escalation analysis, tracking trends and recommending interventions without direct issue handling. • Attend workforce management meetings to align on staffing, service delivery, and operational adjustments. • Support Advocate Team in performance management decision-making by providing data-driven insights and recommendations. Quality & Continuous Improvement: • Support Member Resolution Supervisors/Quality Coaching by facilitating weekly meetings to discuss insights and opportunities. • Bring trend analysis and findings to weekly quality meetings, ensuring overarching process improvements across the book of business (BoB) and pods. • Lead process improvement initiatives, leveraging data insights to enhance service quality and operational efficiency. Data Analysis & Operational Insights: • Analyze and synthesize data related to member experience and operational performance, providing clear insights and recommendations. • Identify emerging issues through operational metrics and collaborate with leadership to implement proactive interventions. • Develop and manage reports on team and pod performance, with a focus on service excellence and member satisfaction. • Investigate and resolve quality issues, risks, and member feedback trends by developing and tracking corrective action plans. • Ensure data integrity by collaborating with other quality team members to align reporting and insights. • Research best practices and external benchmarks to enhance Included Health's service and quality initiatives. • Support audit remediation efforts and compliance-related quality improvement activities. • Lead and participate in cross-functional collaborations to improve quality, safety, and service outcomes. • Perform other duties as assigned. Qualifications: • 3+ years of experience in service quality improvement, healthcare operations, or related fields. • 2+ years of experience creating reports, dashboards, and visualizations to drive performance improvement. • Bachelor's degree required; CPHQ certification or IHI certification preferred. • Experience in quality improvement frameworks (e.g., Lean, Six Sigma), root cause analysis, and process optimization. • Ability to interpret and leverage data to identify trends, test hypotheses, and measure outcomes. • Strong virtual meeting facilitation skills to drive productive discussions and decision-making. • Proficiency in Google Apps and Mac OS for developing tools, reports, and dashboards. • Experience in healthcare settings required; knowledge of member experience metrics is a plus. • Exceptional organizational and communication skills, with the ability to influence stakeholders and drive cross-functional collaboration. • Self-starter with a problem-solving mindset and a proactive approach to identifying and implementing improvements. • Ability to adapt quickly in a dynamic, fast-paced environment while managing multiple priorities. Physical/Cognitive Requirements: • Capability to remain seated in a stationary position for prolonged periods. • Eye-hand coordination and manual dexterity to operate keyboard, computer and other office-related equipment. • Capability to work with leadership, employees, and members in an appropriate manner. The United States new hire base salary target ranges for this full-time position are: Zone A: $81,070.00 - $95,810.00 + equity + benefits Zone B: $89,177.00 - $105,391.00 + equity + benefits Zone C: $97,284.00 - $114,972.00 + equity + benefits Zone D: $105,391.00 - $124,553.00 + equity + benefits This range reflects the minimum and maximum target for new hire salaries for candidates based on their respective Zone. Below is additional information on Included Health's commitment to maintaining transparent and equitable compensation practices across our distinct geographic zones. Starting base salary for you will depend on several job-related factors, unique to each candidate, which may include education; training; skills; years and depth of experience; certifications and licensure; our needs; internal peer equity; organizational considerations; and understanding of geographic and market data. Compensation structures and ranges are tailored to each zone's unique market conditions to ensure that all employees receive fair and great compensation package based on their roles and locations. Your Recruiter can share your geographic zone upon inquiry. Benefits & Perks: In addition to receiving a great compensation package, the compensation package may include, depending on the role, the following and more: Remote-first culture 401(k) savings plan through Fidelity Comprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance) Paid Time Off ("PTO") and Discretionary Time Off (“DTO") 12 weeks of 100% Paid Parental leave Family Building & Compassionate Leave: Fertility coverage, $25,000 for surrogacy/adoption, and paid leave for failed treatments, adoption or pregnancies. Work-From-Home reimbursement to support team collaboration home office work Your recruiter will share more about the salary range and benefits package for your role during the hiring process. About Included Health Included Health is a new kind of healthcare company, delivering integrated virtual care and navigation. We’re on a mission to raise the standard of healthcare for everyone. We break down barriers to provide high-quality care for every person in every community — no matter where they are in their health journey or what type of care they need, from acute to chronic, behavioral to physical. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care. It’s all included. Learn more at includedhealth.com. ----- Included Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics or any other basis forbidden under federal, state, or local law. Included Health considers all qualified applicants with arrest or conviction records in accordance with the San Francisco Fair Chance Ordinance, the Los Angeles County Fair Chance Ordinance, and California law. Job Summary: The Quality Improvement Lead (QIL) plays a critical role in transforming data into actionable insights to enhance the member experience, quality of care, and service excellence. This role helps leaders understand member feedback, assess operational performance, and identify opportunities for scalable improvements. The ideal candidate is passionate about service and care excellence and demonstrates strong analytical skills with an ability to translate data into meaningful improvements. They thrive in a fast-paced environment, take ownership of their work, and collaborate effectively with leadership to drive data-informed decision-making. Responsibilities: Client Engagement & Service Insights: • Interact with and serve as a point of contact for clients, ensuring clear communication and responsiveness to needs. • Manage and respond to client email aliases, ensuring timely and professional communication. • Proactively analyze and identify escalation trends to inform process improvements and enhance client confidence. • Partner with Operations Transformation teams on implementation planning, remediations, and carrier transitions to ensure seamless service. Member Experience & Performance Improvement: • Conduct MSAT (Member Satisfaction) trend analysis, ensuring insights drive action and accountability. • Perform QA and escalation analysis, tracking trends and recommending interventions without direct issue handling. • Attend workforce management meetings to align on staffing, service delivery, and operational adjustments. • Support Advocate Team in performance management decision-making by providing data-driven insights and recommendations. Quality & Continuous Improvement: • Support Member Resolution Supervisors/Quality Coaching by facilitating weekly meetings to discuss insights and opportunities. • Bring trend analysis and findings to weekly quality meetings, ensuring overarching process improvements across the book of business (BoB) and pods. • Lead process improvement initiatives, leveraging data insights to enhance service quality and operational efficiency. Data Analysis & Operational Insights: • Analyze and synthesize data related to member experience and operational performance, providing clear insights and recommendations. • Identify emerging issues through operational metrics and collaborate with leadership to implement proactive interventions. • Develop and manage reports on team and pod performance, with a focus on service excellence and member satisfaction. • Investigate and resolve quality issues, risks, and member feedback trends by developing and tracking corrective action plans. • Ensure data integrity by collaborating with other quality team members to align reporting and insights. • Research best practices and external benchmarks to enhance Included Health's service and quality initiatives. • Support audit remediation efforts and compliance-related quality improvement activities. • Lead and participate in cross-functional collaborations to improve quality, safety, and service outcomes. • Perform other duties as assigned. Qualifications: • 3+ years of experience in service quality improvement, healthcare operations, or related fields. • 2+ years of experience creating reports, dashboards, and visualizations to drive performance improvement. • Bachelor's degree required; CPHQ certification or IHI certification preferred. • Experience in quality improvement frameworks (e.g., Lean, Six Sigma), root cause analysis, and process optimization. • Ability to interpret and leverage data to identify trends, test hypotheses, and measure outcomes. • Strong virtual meeting facilitation skills to drive productive discussions and decision-making. • Proficiency in Google Apps and Mac OS for developing tools, reports, and dashboards. • Experience in healthcare settings required; knowledge of member experience metrics is a plus. • Exceptional organizational and communication skills, with the ability to influence stakeholders and drive cross-functional collaboration. • Self-starter with a problem-solving mindset and a proactive approach to identifying and implementing improvements. • Ability to adapt quickly in a dynamic, fast-paced environment while managing multiple priorities. The salary range for this full time position is $86,410.00 - $113,112.00 per year in the United States. This posted range reflects the portion of our internal pay band that is currently funded for new hires in this role across our standard labor markets (Zones A–C). For context, these markets include Zone A (e.g., Phoenix AZ, San Antonio TX, Columbus OH, Charlotte NC), Zone B (e.g., Chicago IL, Denver CO, San Diego CA, Houston TX), and Zone C (e.g., Los Angeles CA, Seattle WA, Washington, D.C., Boston MA). At this time, we are not budgeting for hires in higher-cost Zone D markets (e.g., San Francisco Bay Area CA, New York City NY, San Jose CA) for this role. Within this range, individual pay is determined by work location, skills, experience, and internal equity. We use structured pay bands and geographic zones based on cost of labor to keep pay fair and consistent. Benefits & Perks: In addition to receiving a great compensation package, the compensation package may include, depending on the role, the following and more: Remote-first culture 401(k) savings plan through Fidelity Comprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance) Paid Time Off ("PTO") and Discretionary Time Off (“DTO") 12 weeks of 100% Paid Parental leave Family Building & Compassionate Leave: Fertility coverage, $25,000 for surrogacy/adoption, and paid leave for failed treatments, adoption or pregnancies. Work-From-Home reimbursement to support team collaboration home office work Your recruiter will share more about the salary range and benefits package for your role during the hiring process. About Included HealthIncluded Health is a new kind of healthcare company, delivering integrated virtual care and navigation. We’re on a mission to raise the standard of healthcare for everyone. We break down barriers to provide high-quality care for every person in every community — no matter where they are in their health journey or what type of care they need, from acute to chronic, behavioral to physical. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care. It’s all included. Learn more at includedhealth.com. -----Included Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics or any other basis forbidden under federal, state, or local law. Included Health considers all qualified applicants with arrest or conviction records in accordance with the San Francisco Fair Chance Ordinance, the Los Angeles County Fair Chance Ordinance, and California law.