Quality Assurance Analyst I

DescriptionNetwork Health's success is deeply rooted in its mission to build healthy and strong Wisconsin communities. This mission shapes every decision we make, including the selection of individuals who join our growing team.The Quality Assurance Analyst I is responsible for identifying quality inefficiencies within the Member Experience call center by monitoring organizational processes, promoting service excellence, and ensuring compliance with quality and operational standards. Key responsibilities include reviewing calls, claims, and other monitoring activities across multiple lines of business. This role conducts weekly and monthly evaluations, reports findings, and supports the development, implementation, and ongoing assessment of quality assurance policies and procedures.Location:Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required), at our office in Brookfield or Menasha, or a combination of both with our hybrid workplace model.Hours:1.0 FTE, 40 hours per week, 8am - 5pm Monday through FridayCheck out our 2025 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.Job ResponsibilitiesPerforms data entry, claim, and call monitoring activities and scores performance according to set criteria and timelinesPerform other operational audits and scores performance according to set criteria and timelines.Trends monitoring results and provides feedback to the Manager of Quality AssuranceCompiles results into meaningful, actionable reports with recommendations for process improvementsDocuments findings and makes recommendations for efficiencies based on monitoring resultsResponsible for accurate and timely performance of monitoring activitiesMaintains and updates tracking databases and/or files to support monitoring activitiesEnsures quality assurance process documentation remains up to dateOther duties as assignedJob Requirements:Associates degree or equivalent work experience requiredBachelor's degree preferred3 or more years of experience working in healthcare or health insurance.One or more years of experience working in one or more of the following: claims, customer service, billing/coding, appeals and grievances or another data entry related position required.Network Health is an Equal Opportunity EmployerEqual Opportunity EmployerThis employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.