Quality Improvement Lead (QIL)

Employment Type: Full-Time

Position Overview

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.

Required Qualifications

• Experience:
  • 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.
  • Experience in healthcare settings required.
  • Experience in quality improvement frameworks (e.g., Lean, Six Sigma), root cause analysis, and process optimization.
• Education:
  • Bachelor's degree required.
• Skills:
  • 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.
  • 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 addressing issues.

Company Information

(No specific company information was provided in the original job description.)