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About the role
- Director of Operational Quality & Governance at Zelis overseeing a team to ensure operational processes are effective and continuously improving with AI capabilities.
Responsibilities
- Oversee daily execution of call monitoring and quality scoring processes
- Own quality scorecards and evaluation frameworks including compliance, customer experience, and service effectiveness criteria
- Ensure consistency, fairness, and calibration across evaluators to minimize scoring variability
- Establish governance for quality standards, scorecards, checklists, peer audit requirements, audit protocols, and performance thresholds ensuring formal documentation, version control, and periodic review
- Partner with Operations leaders to drive targeted improvement plans based on quality outcomes
- Maintain strict adherence to regulatory, contractual, and compliance requirements embedded within scoring models
- Serve as business co-owner of AI-enabled quality capabilities
- Define the post-MVP roadmap for scaling AI-driven quality monitoring, including human-in-the-loop governance
- Partner with Technology and AI teams to refine scoring models, evaluation logic, and data feedback loops
- Establish controls to ensure AI-driven scoring maintains compliance rigor and audit defensibility
- Evaluate emerging capabilities (e.g., real-time guidance, next-best-action support) for potential impact on quality and partner with Operations leadership on strategy and roadmap
- Drive value realization, adoption metrics, and operational impact measurement of AI-enabled quality tools
- Analyze recurring scoring patterns to identify systemic process, platform, training, or design signals for improvement opportunity
- Build structured escalation and improvement pathways that feed into broader process excellence initiatives
- Lead targeted continuous improvement initiatives where quality data indicates systemic risk or opportunity
- Develop dashboards and executive-ready reporting that translate quality metrics into operational insights and strategic decisions
- Partner cross-functionally to drive durable process redesign
- Lead, mentor, and develop a team of quality professionals and analysts
- Foster a culture of accountability, objectivity, continuous improvement, and operational excellence
- Define role clarity, performance expectations, and capability development pathways
- Ensure appropriate resourcing models across onshore and offshore quality monitoring needs
- Build scalable governance processes that support business growth without linear headcount expansion
Requirements
- Bachelor’s degree with 15+ years of relevant experience or Master’s degree with 10+ years
- 8+ years of progressive leadership experience managing multi-level teams in operations or quality environments
- Expertise in contact center quality assurance and compliance-based scoring frameworks
- Demonstrated experience building or governing independent audit or quality oversight functions
- Strong background in continuous improvement methodologies (Lean Six Sigma Black Belt or Master Black Belt strongly preferred)
- Experience translating operational data into enterprise-level improvement initiatives
- Proven ability to influence cross-functional leaders and drive alignment without direct authority
- Experience partnering with Technology teams on AI-enabled or automation-driven solutions
- Proficiency using AI tools skillfully with an understanding of how to develop intelligent prompts and/or agents
- Strong executive communication skills, with the ability to present insights clearly to senior leadership
- Experience operating in regulated healthcare, payer, or financial environments strongly preferred.
Benefits
- Hybrid and remote friendly culture
- Professional development opportunities
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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