Quality Assurance Analyst

The pay range above represents the minimum and maximum rate for this position in California. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. Salary range will vary for remote positions outside of California and future increases will be based on the pay band for the city and state you reside in.

Work Culture:

GCHP strives to create an inclusive, highly collaborative work culture where our people are empowered to grow and thrive.  This philosophy enables us to create the health plan of the future and do our best work – Together.

GCHP promotes a flexible work environment. Employees may work from a home location or in the GCHP office for all or part of their regular workweek (see disclaimer).

GCHP’s focuses on 5 Core Values in the workplace:

•    Integrity

•    Accountability

•    Collaboration

•    Trust 

•    Respect

Disclaimers:

•    Flexible work schedule is based on job duties, department, organization, or business need.

•    Gold Coast Health Plan will not sponsor applicants for work visas.

POSITION SUMMARY

The Quality Assurance (QA) Analyst supports the continuous improvement of service delivery within the member and provider contact centers. This role involves evaluating representative performance using a DHCS-provided scorecard, ensuring compliance with established quality standards, and assisting with agent development through coaching and feedback. The QA Analyst may also participate in score dispute resolution and calibration sessions to ensure consistent evaluation practices.

Amount of Travel Required: 5%

Reasonable Accommodations Statement

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

ESSENTIAL FUNCTIONS

Job Function & Responsibilities

Performance Monitoring:

•    Evaluate call recordings and interactions based on DHCS scorecard and internal quality standards.

•    Ensure the required volume of calls is reviewed to meet compliance and internal targets.

•    Document and report performance trends, identifying gaps and opportunities for improvement.

Coaching & Feedback:

•    Provide actionable feedback to agents to enhance their performance and ensure service standards are met.

•    Facilitate 1:1 coaching sessions or assist supervisors in delivering performance feedback.

•    Participate in team calibration sessions to align on scoring consistency and ensure fairness across evaluations.

Dispute Resolution:

•    Participate in the agent score dispute process to address discrepancies in performance assessments.

•    Collaborate with supervisors and agents to resolve disputes and maintain transparency.

Collaboration & Reporting:

•    Partner with Contact Center leadership to identify trends and recommend process improvements.

•    Provide regular reporting on QA performance metrics to management.

•    Collaborate with the training and operations teams to ensure feedback is integrated into training programs.

MINIMUM QUALIFICATIONS

Education & Experience: 

•    Bachelor’s degree or equivalent work experience in a related field (preferred).

•    2-3 years of experience in a quality assurance role within a contact center environment.

•    Experience working with healthcare plans or regulated industries preferred.

Equivalent In lieu of degree: Will accept a minimum of 2-3 years of related experience must be added in lieu of a bachelor’s degree.

KNOWLEDGE, SKILLS & ABILITIES

Preferred Qualifications:    

•    Experience within healthcare, insurance, or other regulated industries preferred.

•    Familiarity with DHCS scorecards and compliance standards a plus.

Technology & Software Skills: Advanced computer skills in MS Office products.

Certifications & Licenses: A valid and current Driver's License, and Auto Insurance

Competency Statements

•    Management Skills - Ability to