Director of Quality and Continuous Improvement, Member Care

🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🔴 Lead

👔 Director

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Sidecar Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2018

⚕️ Healthcare Insurance

Healthcare Insurance

Sidecar Health is a health insurance company that provides comprehensive major medical insurance with upfront pricing and no network restrictions or referral requirements. Their goal is to put employees in control of their healthcare by giving them a clear budget for care and allowing them to choose any doctor without surprise costs. They emphasize access to prescriptions without limitations and protection for unplanned care. Sidecar Health also offers transparent pricing and the option for members to save money if they find providers who charge less than their plan pays. Their offerings include individualized access plans and employer plans, ensuring members always have a choice of qualified doctors.

📋 Description

• 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 • 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 • Build 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 • 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.

🎯 Requirements

• 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.

🏖️ Benefits

• Competitive salary, bonus opportunity, and equity package • Comprehensive Medical, Dental, and Vision benefits • A 401k retirement plan • Paid vacation and company holidays • Opportunity to make an impact at a rapidly growing mission-driven company transforming healthcare in the U.S.