Quality Assurance Lead - Healthcare (BOG)

Position Summary

Operating within a BPO environment, the Quality Lead evaluates interactions across every operational team, serving as the core anchor for performance alignment, comprehensive quality assurance, and robust audit frameworks. 

In this specialized healthcare capacity, the Quality Lead manages direct client communications, conducts hands-on audits for enrollment accounts, and ensures strict alignment with U.S. healthcare workflows, patient communication standards, and zero-tolerance regulatory compliance.

Key Responsibilities

• Quality Governance: Serve as the central Quality Lead overseeing end-to-end Quality Assurance standards, audit frameworks, and accuracy benchmarks across all internal and partner operational teams.
• Direct Auditing & Performance Evaluation: Directly perform structured quality evaluations across email, chat, and voice channels for enrollment associates to monitor scoring accuracy, workflow execution, and adherence to operational SLAs.
• Operational Calibration: Organize and facilitate regular calibration sessions to maintain 100% alignment against standardized QA rubrics and enrollment protocols.
• Healthcare & Enrollment Compliance Auditing: Conduct targeted compliance audits on enrollment verification workflows, patient privacy standards, HIPAA/HITECH guidelines, and client-specific medical communication protocols.
• Data Analysis & Insight Synthesis: Analyze weekly quality metrics, root-cause error trends, and evaluation data. Convert findings into actionable feedback for leadership and training teams to eliminate performance gaps.
• Workflow Optimization & Continuous Improvement: Develop and implement monthly targeted quality action plans aimed at enhancing key enrollment metrics, elevating patient and member experience ratings, refining the QA framework, and driving operational process adherence.
• Onboarding & Operational Readiness: Assist the QA Manager by building initial enrollment evaluation forms, establishing audit workflows, and running baseline readiness audits during launch phases.
• Client & Stakeholder Engagement: Foster strong working relationships with key stakeholders through clear, professional, and impactful communication across all channels.

• English Proficiency: Demonstrated advanced, near-native fluency in English (both spoken and written) is mandatory.
• Healthcare Enrollment Expertise: Deep functional knowledge of healthcare enrollment workflows, eligibility verification, patient onboarding fundamentals, and clinical account processes.
• Data Analysis: Advanced proficiency in Microsoft Excel or Google Sheets to aggregate performance data, track trend lines, and build basic reporting dashboards.
• Problem Solving: Ability to evaluate complex customer service or healthcare workflow errors, identify root causes, and suggest practical remediation steps.
• Client Management & Stakeholder Communication: Proven track record of managing direct client relationships, leading operational client reviews, presenting quality/performance metrics, and proactively aligning training and quality standards with client requirements. 
• Effective Communication: Exceptional written, verbal, and presentation skills tailored for executive leadership, external clients, and front-line operational teams. 
• Healthcare Compliance: Strong understanding of HIPAA/HITECH regulations, Protected Health Information (PHI) protocols, and patient privacy standards.
• Quality Auditing & Analysis: Hands-on experience evaluating multi-channel communications (voice, email, chat), analyzing root-cause error trends, synthesizing data into actionable feedback, and facilitating operational calibration sessions
• Process Management: Strong organization skills to balance daily auditing targets, calibration schedules, and special quality projects without sacrificing scoring integrity.

Education and Experience

• Minimum 2 years of proven experience in a Quality Assurance Lead or Senior Specialist role within a BPO environment (required)
• Minimum of 1 year of direct experience supporting Healthcare accounts or handling protected health information (PHI).
• Advanced English proficiency (written and verbal)
• On-site role in Bogota.