Operations AI Analyst Q-1

We’re looking for a detail-driven operations professional with a strong focus on member experience who is eager to work hands-on with AI and support accurate, compliant, and AI-powered member interactions. The ideal candidate will bring healthcare experience, including knowledge of Medicare and Medicaid, along with experience supporting or optimizing AI-enabled user experiences. Experience with Star Ratings programs and initiatives is also preferred.

About the role

In this role, you’ll provide day-to-day operational oversight of our member-facing virtual assistant, partnering closely with the Senior Operations AI Analyst and technical teams. You’ll monitor performance, validate outcomes for accuracy, quality, and compliance, document operational requirements, and execute testing and validation to ensure AI releases are safe, stable, and scalable. Success means proactively identifying opportunities for improvement, delivering consistent and compliant member interactions, establishing standardized and repeatable operational processes, and helping build a scalable, enterprise-ready virtual assistant that enhances the member experience and supports organizational goals, including quality and Star Ratings outcomes.

This is a remote role with occasional travel to BCBST headquarters. Sponsorship is not available for this role.

Responsibilities

• Execute daily operations of AI-enabled member service processes across multiple channels
• Monitor performance and review interaction outcomes for accuracy, quality, and compliance
• Analyze escalations and exceptions to surface trends, risks, and improvement opportunities
• Document business and functional requirements: workflows, procedures, user stories, acceptance criteria, and test scenarios
• Lead user acceptance and regression testing to validate operational readiness
• Maintain issue and defect logs; coordinate resolution with cross-functional partners
• Produce clear operational documentation, standard work, and runbooks
• Partner with Operations, Quality, IT, Analytics, and vendor teams on continuous improvement

Requirements

• Bachelor’s degree or equivalent work experience (four years of professional work experience in a corporate environment)
• 3 to 4 years in service operations, operations analysis, quality, reporting, business analysis, or contact center environments
• Proven ability to translate operational processes into clear, structured documentation
• Experience supporting testing activities and validating operational readiness
• Comfortable working in cross-functional, fast-moving, operations-focused teams

Skills

• Strong analytical and problem-solving skills
• Ability to translate operational workflows into clear, structured documentation
• Proficiency with Microsoft Office tools including CoPilot
• Ability to manage multiple priorities with minimal supervision in a collaborative environment