Quality Management Specialist
Job Summary
The Total Quality Management Specialist is responsible for upholding quality standardization across all lines of business. This role focuses on providing expert oversight, identifying performance gaps, and facilitating cross-functional calibrations. You will maintain program reliability while resolving high-complexity cases and supporting new quality initiatives.
Responsibilities
- Standardize quality evaluation rubrics
- Resolve high-complexity case workflows
- Oversee escalated transaction resolution
- Support AI-driven quality initiatives
Required Skills
- Bilingual (Spanish)
- Healthcare quality assurance
- Quantitative and analytical skills
- Data management (G-Sheets)
- Peer coaching and auditing
Job Details
### Responsibilities:
- Maintain the health and reliability of quality programs across all lines of business by ensuring standardization and consistent application of evaluation rubrics.
- Evaluate and resolve high-complexity cases that fall outside conventional workflows, focusing on root-cause identification and systemic resolution.
- Oversee internal and external escalated transactions to ensure resolutions meet both service-level agreements and quality benchmarks.
- Serve as the Subject Matter Expert for quality standards and cross-functional feedback.
- Support the testing and implementation of new quality programs, workflows, and audit approaches, including AI-driven initiatives.
- Compliance with all applicable laws and regulations.
- Other duties as assigned.
### Requirements:
- Bilingual in Spanish.
- 1+ years previous work experience in healthcare environment and quality assurance.
- 1+ years of experience demonstrating strong quantitative and analytical skills, with a focus on proactively identifying issues and driving solutions.
- Experience coaching peers or auditors.
- 1+ years experience working with data and g-sheets reviewing data.
### Bonus points:
- Auditing and quality experience.
- Experience in AI auditing programs.
- Advanced Operations Certificate (Lean Six Sigma or similar).
- Previous project oversight experience.