Opportunity Overview:
As Quality Specialist will implement quality measurements, scoring, and performance improvement data designed to improve operational efficiency while exceeding industry standards for quality performance. You will apply subject-matter expertise to guide and support the training and quality needs of Intake Operations. This includes building the success of the company through training and development. With a solid foundation in quality analysis, feedback, instructing/coaching; you are expected to be flexible and nimble in your role to manage short- and long-term projects as well as dealing with day-to-day QA tasks. Cohere culture is one of partnership and ownership.
What you’ll do:
- Translate QA findings into clear insights and recommendations for operational leaders and cross-functional partners.
- Develop and deploy structured coaching sessions based on audit findings to improve accuracy, decision-making, and skill development.
- Create and ensure accuracy of SOPs, job aids, workflow guides, and new product readiness materials.
- Facilitate onboarding and ongoing upskilling sessions using adult learning principles and SME feedback.
- Lead QA/Training side of project implementations by operationalizing workflow changes, quality expectations, and training updates into the business.
- Partner with Product, Clinical, Client Services, and Operations to validate workflow changes and identify potential quality or compliance risks.
- Support change management by communicating process updates and aligning QA expectations across impacted teams.
- Serve as a subject matter expert and advisor to frontline leaders on quality trends, training needs, and operational readiness.
- Manage multiple concurrent priorities with independence, ownership, and accountability for deliverables, exercise discretion and independent judgment.
- Step into operational queues to maintain service levels and ensure continuity of operations, as needed during high-volume periods.
- Other duties as assigned
Required Qualifications:
Must-haves
- 5 to 7 years of experience in US Healthcare Payer Processes
- Experience in US healthcare operations, medical billing, claims, or prior authorization.
- Experience in healthcare BPO/KPO, payer/provider operations, or contact center environments.
- Knowledge of HIPAA regulations and patient privacy practices.
- Bachelor’s degree or equivalent experience preferred.
- 3+ Yrs in Quality assurance role.
- Attention to detail
- Communication skills - verbal and written
- Data collection, management and analysis
- Problem analysis and problem solving
- Planning and organizing
- Effective interaction with stakeholders
- Teamwork
- Comfort working in a Mac-based environment
Nice-to-haves
- Proficiency with Google Workspace (Sheets, Docs, Forms); ability to build pivot tables and create charts or dashboards
- Experience identifying performance trends and root causes through data
- Experience using quality management systems and conducting structured QA audits
- Experience facilitating coaching sessions and giving constructive feedback
- Understanding of Adult Learning Theory and Training
ISMS roles and responsibilities
- Fair understanding of Information Security practices.
- Align to the organization policies and procedures.
- Ensure to get updated with ISMS roles as assigned by the department/process heads.
Ability to commute/relocate:
- Hyderabad, Telangana: Reliably commute or planning to relocate before starting work (Preferred)
Interview Process*:
- Connect with Talent Acquisition
- Meet with the Hiring Manager
- Behavioral Interview(s)
- Case Study
- Interview with Senior Leadership
*Subject to change
About Cohere Health:
Cohere Health’s clinical intelligence platform and agentic AI-powered solutions connect health plans’ strategic goals and providers’ needs, optimizing the speed, cost, and quality of care. With an enterprise approach that streamlines payer-provider decision-making across the care continuum–including policy, prior authorization, payment accuracy, and more–the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.
With the acquisition of ZignaAI, we expanded our AI-native platform with a comprehensive Payment Integrity Suite that spans data mining, clinical and coding validation, authorization and claims reconciliation, and end-to-end payment integrity services across pre- and post-pay workflows. By connecting clinical and payment insights, our transparent, AI-powered solutions help health plans proactively improve payment accuracy, reduce waste and vendor dependency, strengthen provider relationships, and build smarter, more efficient payment integrity programs.
Cohere Health’s innovations continue to receive industry-wide recognition. We’ve been recognized on TIME’s World Top HealthTech Companies 2025 list, the 2025 Inc. 5000 list, in the Gartner® Hype Cycle™ for U.S. Healthcare Payers (2022-2025), and ranked as a Top 5 LinkedIn™ Startup for 2023 & 2024.
We can’t wait to learn more about you and meet you at Cohere Health!
Equal Opportunity Statement:
Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, it’s personal.