Quality Assurance Analyst Sr. (Finance)

We offer remote work opportunities (AK, AR, AZ, *CO, FL, *HI, IA, ID, *IL, KS, LA, MD, *MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, *WA, WI & WY only).

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Veterans, Reservists, Guardsmen and military family members are encouraged to apply!

Job Summary

The Senior Quality Assurance Analyst (QA) for the TRICARE Contact Center is responsible for ensuring that the contact center delivers the highest quality of customer service to TRICARE beneficiaries and stakeholders. This role focuses on maintaining and improving quality standards across all customer interactions by evaluating call quality, providing feedback to agents, and implementing processes that ensure compliance with TRICARE policies and industry standards. The Senior QA Analyst leads quality initiatives, collaborates with leadership teams, and helps drive continuous improvement efforts.

Education & Experience

Required:

• Bachelor's Degree or equivalent experience
• U.S. Citizenship
• Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
• Minimum of 5 years of experience in quality assurance, with at least 2 years of experience in a contact center or customer service environment
• Strong analytical skills with the ability to assess data and make actionable recommendations
• Excellent verbal and written communication skills, with the ability to provide constructive feedback in a clear and professional manner
• Experience with quality monitoring software and tools; familiarity with CRM systems and telephony platforms is a plus
• Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint)

Preferred:

• In-depth knowledge of TRICARE program guidelines, policies, and procedures is highly preferred
• Certification in Quality Assurance (e.g., Six Sigma, CQIA) is a plus
• Experience mentoring and coaching contact center staff
• Veteran, military spouse or military affiliated
• Healthcare or insurance industry experience
• Experience with process improvement methodologies such as Lean or Six Sigma

Key Responsibilities

• Conduct thorough and accurate quality assessments of phone calls, emails, and other customer interactions to ensure adherence to TRICARE standards, policies, and regulations.
• Provide detailed feedback to contact center agents, performance coaches and supervisors on performance, including recommendations for improvement.
• Develop, update, and implement, checklists, and scorecards that align with TRICARE quality requirements and best practices.
• Identify trends in quality issues and collaborate with the Performance Coaching, Training and Operations teams to address skill gaps and process improvements.
• Work with leadership to establish key performance indicators (KPIs) for quality monitoring and reporting.
• Conduct root cause analysis on quality issues, develop action plans, and track results to ensure continuous improvement.
• Monitor adherence to TRICARE's compliance requirements and customer service standards, ensuring that all interactions meet legal and contractual obligations.
• Lead regular calibration sessions with team members to ensure consistency and accuracy in quality scoring.
• Generate and analyze reports on quality metrics, providing insights to leadership for performance tracking and strategic planning.
• Support audits and compliance assessments, ensuring that contact center practices align with TRICARE's policies and contractual requirements.
• Mentor and provide training to junior QA analysts to build a strong quality assurance team.
• Collaborate with cross-functional teams (Performance Coaching, Training, Operations, Workforce Management) to enhance overall contact center performance and customer satisfaction.
• Assist Knowledge Management in the development and delivery of quality assurance-related training materials for new hires and ongoing development programs.
• Takes active steps to continually expand personal knowledge and expertise in all aspects of the TRICARE program. Participates in and represents the Corporate Operations departments in other process and performance improvement projects and meetings, utilizing Six Sigma or other quality tools as required as part of project.
• Serves as a subject matter expert and resource to Quality Assurance team, Corporate Operations, and other TriWest staff.
• Regular and reliable attendance is required.

Competencies

Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate.

Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.

Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.

High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.

Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.

Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.

Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.

Technical Skills: Knowledge of quality assurance programs in an inbound call center environment, quality tools and models, and TRICARE programs; expertise with adult training techniques and concepts; proficient with records maintenance and call center software; proficient with Microsoft Office Suite including; Word, Excel, PowerPoint, Visio and Outlook

Working Conditions

Working Conditions:

• Works in a remote environment, with minimal travel
• Extensive computer work with prolonged sitting
• Travels approximately 10% or 5 weeks per year
• Department of Defense security clearance required

Company Overview

Taking Care of Our Nation's Heroes.

It's Who We Are. It's What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve®!

Our job is to make sure that America's heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.

DoD Statement

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Benefits

We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

• Medical, Dental and Vision Coverage
• Generous paid time off
• 401(k) Retirement Savings Plan (with matching)
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
• Tuition reimbursement
• Paid volunteer time

*Annual base salary for Colorado, Hawaii, Illinois, Minnesota, Washington D.C. and Washington State residents: $52,000 - $67,000 depending on experience*

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.