Quality Assurance Analyst – Customer Care

Capital Rx

Quality Assurance Analyst responsible for evaluating customer care performance within a healthcare technology company. Focusing on adhering to customer service standards and regulatory compliance.

Posted 6/16/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $71,200 - $112,000 per yearWebsite

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

quality assurancedata analysisperformance reportingcustomer satisfaction (CSAT)compliance procedurescalibration sessionstraining needs assessmentcall center operationsHIPAAMedicare

Soft Skills

customer serviceanalytical skillsorganizational skillsprocess developmentcoachingself-startercollaborationcommunication

Certifications & Qualifications

Bachelor's degree

Industry Keywords

healthcarePBMquality scorecardscustomer interactionsmember complaintsAOR formspolicy violations

About the role

Key responsibilities & impact

Collaborate with leadership to develop and maintain customer care quality scorecards
Conduct quality evaluations of recorded and live customer interactions
Assess agent adherence to procedures and compliance procedures
Facilitate and participate in calibration sessions
Support Customer Satisfaction (CSAT) calibration efforts
Analyze QA data and reporting to identify trends
Provide performance reporting and support to supervisors
Identify training needs through QA evaluations
Oversee the end-to-end processing of member complaints and grievances
Review, document, and research Authorized Representative (AOR) forms
Ensure timely and accurate completion of QA reporting
Handle inbound or outbound calls as needed
Report any compliance concerns or policy violations

Requirements

What you’ll need

4+ years’ experience with call center operations, with at least 2 years of experience with Quality Assurance or training
PBM or Healthcare call center operations experience preferred
Bachelor’s degree preferred, or equivalent experience
Knowledge of HIPAA and Privacy Rule regulations
Knowledge of Medicare
A self-starter with outstanding customer service skills
Demonstrate aptitude to develop processes and coach frontline customer service employees
Strong analytical and organizational skills

Benefits

Comp & perks

Health insurance
Retirement plans
Paid time off
Flexible work arrangements