Healthcare QA Specialist — Coaching Operations Quality

ConnectiveRx; Pittsburgh (Allegheny County); On-site; USD 21,000 - 32,000; Full time

Benefits offered by this job

Bonus eligibility

Comprehensive benefits (medical, dent,

401(k) plan with employer contribution

PTO & holidays

Job summary

ConnectiveRx is seeking an Operations Quality Assurance Associate I in the Pittsburgh area. You will evaluate Operations Agents' work against SOPs and program rules, providing coaching to improve quality and drive operational excellence.

The role requires critical thinking and objective decision-making to ensure adherence to standards. As a SME for assigned units, you will review data, processes, and workflows, and support calibration meetings with internal, vendor, and client teams.

Qualifications

• High school diploma or equivalent required.
• 0-2 years of experience as a Case Manager, Benefit Verification Specialist, Contact Center Agent, or in a similar role.
• Experience in healthcare operations, customer service, or quality assurance environments preferred.
• Working knowledge of quality-focused services, including accuracy management, performance metrics, customer experience, healthcare benefits, and SOP execution.

Responsibilities

• Coach Operations Agents through peer-to-peer feedback on opportunities identified during quality evaluations.
• Partner with Training to support new hire, refresher, and nesting training programs.
• Perform and document quality assurance evaluations across operational products and services, including benefit verification cases, patient assistance cases, software support calls and emails, inbound calls from patients and healthcare providers, data entry activities, and other operational functions.
• Participate in internal, vendor, and client calibration meetings related to quality initiatives.
• Identify and appropriately escalated critical quality concerns to senior management.
• Support additional quality assurance functions and responsibilities as needed to help achieve department and company goals.
• Be available to work occasional evening and/or weekend hours based on business needs.
• Audit work completed by Operations Agents.
• Perform other duties as assigned.

Skills

Quality Assurance

Coaching

Microsoft Office

Bilingual English/Spanish

Analytical

Communication

Training support

Education

High school diploma

Tools

Microsoft Office Suite

Job description

ConnectiveRx is seeking an Operations Quality Assurance Associate I in the Pittsburgh area. You will evaluate Operations Agents' work against SOPs and program rules, providing coaching to improve quality and drive operational excellence.

The role requires critical thinking and objective decision-making to ensure adherence to standards. As a SME for assigned units, you will review data, processes, and workflows, and support calibration meetings with internal, vendor, and client teams.