Director of Quality and Continuous Improvement, Member Care
Sidecar Health · United States · 2 mo ago
RemoteRemoteManagementFull-time
About the Role
We're seeking for a Director of Quality and Continuous Improvement who can lead from both ends of the strategy-to-execution spectrum. The role is structured around two distinct functions: (1) overhauling how we approach quality assurance, leveraging AI and speech analytics to shift from manual, sample-based review to continuous, intelligent insights; and (2) converting those signals into action across the organization — whether through training, documentation and SOPs, or broader cross-functional process improvement.
Key Responsibilities
Quality Strategy & AI Evolution (40%)
- Own the Quality evolution roadmap, including the transition from manual, sample-based evaluation to AI-powered scoring, automated coverage, and always-on quality insights
- Leverage AI, speech analytics, and interaction data to surface actionable coaching and process improvement opportunities
- Design and maintain quality scorecards, evaluation criteria, and calibration standards – leading sessions calibration sessions to ensure consistency across evaluators and time
- Perform deep-dive analysis on quality trends, complaints, and outliers, generating executive-level reports with actionable insights
Converting Insight into Action (30%)
- Design feedback loops connecting quality insight to action – whether that’s coaching, training updates, documentation changes, workflow updates, or technology needs
- Conduct structured root cause analysis on critical failures, escalations, and member complaint trends
- Create business cases for improvement initiatives with clear ROI projections and measurable impact
- Pilot and test new processes, workflows, and member interaction scripts before scaling; create and maintain SOPs and documentation standards
Team and Stakeholder Leadership (30%)
- Partner with the Member Services leadership team to define and execute a multi-year Quality Assurance and Continuous Improvement strategy aligned to company growth objectives
- Build, lead, and develop a team of QA analysts and continuous improvement practitioners including certification pathways, analyst development tracks, and Green/Black Belt mentorship
- Represent operational excellence in cross-functional forums, present findings, risks, and recommendations to executive leadership
- Champion a continuous improvement culture across Member Services, partnering with Operations, Technology, Product, Training, and Compliance on integrated initiatives
- Ensure compliance with healthcare regulations (HIPAA, CMS, state requirements), partner with Legal and Compliance teams on audit readiness, and lead corrective action plans
Required Qualifications
- 8-10 years of progressive experience in process excellence, quality management, or operational improvement, with 3-5 years in leadership roles
- Bachelor’s degree in business administration, Operations Management, Healthcare Administration, or related field
- Demonstrated application of methodology in a contact center or healthcare services environment
- Direct experience with quality monitoring, scorecards, contact center analytics, and coaching leaders with documented performance outcomes
- Hands-on experience directing or implementing AI-powered quality tools, speech analytics platforms, or automated scoring systems
- Demonstrated ability to translate quality analytics into business recommendations for executive audiences
- Understanding of healthcare regulations: HIPAA, ACA, CMS, and state insurance compliance requirements
- Strong executive presence with excellent facilitation, coaching, and communication skills across all organizational levels
- Analytical mindset with experience in statistical analysis and converting data into actionable operational decisions
- Bias toward action, rapid iteration, and an entrepreneurial approach to problem-solving
Preferred Qualifications
- Lean Six Sigma Green Belt or Black Belt strongly preferred
- Additional certifications in COPC, Project Management (PMP), or Change Management
- Experience in high-growth healthcare technology or insurtech with contact center operations background
- Familiarity with Genesys Cloud, or CRM-integrated quality tools