At Clover Health, every member interaction builds trust and shapes health outcomes. We are hiring a Quality Assurance Lead to own and mature the Quality Assurance program for Clover's Houston Experience Center, holding every member interaction to our standards for accuracy, empathy, compliance, and service.
You will own the end-to-end program: standards, scorecards, calibration, governance, reporting, appeals, and continuous improvement. You will lead a team of QA analysts and partner with Operations, Training, HR, Compliance, and Member Experience leadership to turn quality insights into improvements for members, agents, and leaders. The role asks for objectivity and partnership at once: QA here is developmental, using data to find trends and turn them into coaching that moves performance.
As our Quality Assurance Lead, you will:
Program Leadership
- Own and evolve the QA program across all member interaction channels, including the standards, scorecards, rubrics, and evaluation methods that align to Clover's member experience commitments and Medicare Advantage quality measures, and serve as the QA subject matter expert for the Houston Experience Center.
- Keep evaluations fair, consistent, and timely, supported by documented standards, governance, and scalable processes that hold regulatory and operational compliance.
- Evaluate emerging QA technology, including AI-assisted review tools, to expand coverage and consistency while keeping the program developmental and human-centered.
Quality Governance & Calibration
- Lead the quality review process and facilitate recurring calibration with Team Leads, Trainers, and Member Experience leadership to hold scoring consistency across reviewers.
- Own QA governance: inter-rater reliability, quality audits, appeals, reviewer development, documentation, and the policies that keep the program transparent and trusted.
- Serve as the primary escalation point for complex quality disputes, and partner with Training, Compliance, HR, Product, and Operations to resolve the systemic issues quality reviews surface.
Performance Insights & Continuous Improvement
- Analyze quality data to surface performance trends, coaching opportunities, knowledge gaps, and systemic issues affecting the member experience.
- Build dashboards and executive reporting, and bring data-driven recommendations that shape operational strategy and leadership decisions.
- Partner with Operations, Training, and Member Experience leadership so quality findings drive coaching strategies, training priorities, and process improvements that reduce recurring issues.
Success in this role looks like:
In the first 90 days, Put consistent QA processes in place, improved velocity, and delivered quality reporting that leaders trust and act on.
By six months, Governance is stronger, meaningful quality trends are identified, and coaching effectiveness and member experience outcomes have improved through partnership with leaders.
You should get in touch if:
- You have 7+ years in Quality Assurance, contact center operations, customer experience, or operational excellence, including leading a QA program.
- You have designed, implemented, or scaled Quality Assurance programs in healthcare, insurance, or another regulated customer service environment.
- You know quality methodologies, calibration, scorecard development, and performance analytics in depth.
- You have used quality data to influence operational strategy and improve customer outcomes.
- You build dashboards and executive-level reporting, and you present recommendations to senior leadership clearly in writing and in person.
- You lead cross-functional initiatives and influence stakeholders without direct authority.
- You balance accountability with coaching and build trusted partnerships across Operations, Training, HR, and Compliance.
- Experience supporting Medicare Advantage, CMS quality programs, CAHPS, HIPAA, or regulated contact center environments is strongly preferred.
- Experience with quality management platforms, speech analytics, AI-assisted QA, or business intelligence tools is a plus.
Benefits Overview:
- Financial Well-Being: Our commitment to attracting and retaining top talent begins with a competitive base salary and equity opportunities. Additionally, we offer a performance-based bonus program, 401k matching, and regular compensation reviews to recognize and reward exceptional contributions.
- Physical Well-Being: We prioritize the health and well-being of our employees and their families by providing comprehensive medical, dental, and vision coverage. Your health matters to us, and we invest in ensuring you have access to quality healthcare.
- Mental Well-Being: We understand the importance of mental health in fostering productivity and maintaining work-life balance. To support this, we offer initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy. Additionally, we embrace a remote-first culture that supports collaboration and flexibility, allowing our team members to thrive from any location.
- Professional Development: Developing internal talent is a priority for Clover. We offer learning programs, mentorship, professional development funding, and regular performance feedback and reviews.
Additional Perks:
- Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities
- Paid parental leave for all new parents
- And much more!
About Clover: We are reinventing health insurance by combining the power of data with human empathy to keep our members healthier. We believe the healthcare system is broken, so we've created custom software and analytics to empower our clinical staff to intervene and provide personalized care to the people who need it most.
We always put our members first, and our success as a team is measured by the quality of life of the people we serve. Those who work at Clover are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.
From Clover’s inception, Diversity & Inclusion have always been key to our success. We are an Equal Opportunity Employer and our employees are people with different strengths, experiences, perspectives, opinions, and backgrounds, who share a passion for improving people's lives. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion and many other parts of one’s identity. All of our employee’s points of view are key to our success, and inclusion is everyone's responsibility.
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Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. We are an E-Verify company.
