Lead Healthcare Operations Analyst

Monitor healthcare service, claims, enrollment, and support operations to identify risks and process gaps. Review calls, transcripts, claims, and enrollment activity; coordinate issue triage and resolution; support team readiness; verify corrective actions; and report findings and progress to project leadership.

Responsibilities

• Monitor customer service, claims, enrollment, and related functions for gaps, trends, and operational risks.
• Review calls, transcripts, claims, and enrollment records to identify misinformation, process breakdowns, and training needs.
• Establish issue intake, triage, ownership, escalation, and resolution processes.
• Support training and role-based readiness for impacted teams.
• Implement quality controls, verify corrective actions, and assess whether changes are effective.
• Maintain an integrated issue tracker and provide concise updates on risks, decisions, and progress.

Required Skills

• Healthcare operations monitoring
• Customer service operations
• Claims review
• Enrollment review
• Call monitoring
• Transcript analysis
• Quality assurance
• Issue triage and management
• Operational risk assessment
• Executive-level reporting