Contact Center Quality Specialist

Key Responsibilities

• Work with leadership team to refine AI-driven quality models to evaluate call handling, documentation accuracy, and eligibility case processing.
• Validate AI-generated quality scores, insights, and flags to ensure alignment with approved quality standards, SOPs, and regulatory requirements.
• Perform human-in-the-loop reviews of selected calls and cases to verify AI accuracy and identify model gaps or bias.
• Recommend to leadership adjustments to AI scoring logic, thresholds, and evaluation criteria based on validation findings.
• Validate AI reviews of inbound and outbound calls for accuracy, professionalism, compliance, and policy adherence.
• Partner with leadership on AI-driven audits of eligibility cases within the CRM system to confirm data integrity, completeness, and correct eligibility determinations.
• Identify trends and systemic issues surfaced by AI analytics and escalate findings to Quality and Operations leadership.
• Partner with leadership to determine standards for AI detection and classification of potential adverse event calls and documentation.
• Ensure AI workflows correctly identify, capture, and route adverse events in accordance with pharmacovigilance and regulatory requirements.
• Partner with Safety and Compliance teams to address AI accuracy issues related to adverse event handling and reporting.
• Lead AI quality calibration sessions with Quality leadership, Operations, and Training teams to ensure alignment between AI output and business expectations.
• Maintain governance documentation for AI quality rules, scoring logic, and validation protocols.
• Support continuous improvement initiatives by ensuring AI quality remains consistent across agents, programs, and call types.
• Support Respond to internal, client, and external data validation audits related to AI-generated quality results.
• Provide validation evidence, test results, and documentation supporting the accuracy and reliability of the AI quality system.
• Conduct periodic validation testing.

Qualifications

• Required: Associate or bachelor’s degree (or equivalent experience).
• Required: 2+ years of call center experience, preferably in healthcare, pharmaceutical, patient assistance, or regulated environments.
• Preferred: Experience supporting pharmaceutical manufacturer foundations or patient support programs.
• Preferred: Experience working with quality monitoring tools or advanced speech analytics platforms.
• Preferred: Knowledge of eligibility processing, CRM systems, and data quality standards.
• Preferred: Understanding of adverse event reporting concepts and compliance requirements.
• Preferred: Familiarity with FDA pharmacovigilance concepts and adverse event workflows.
• Preferred: Experience supporting audits or compliance validation efforts.
• Preferred: Exposure to AI governance, model validation, or quality technology implementations.