Role Description Your Way Insurance is seeking a Director of Quality Assurance & Artificial Intelligence to join its growing Legal & Compliance department. This role will serve as a strategic leader, thinker, and business partner to one of the largest and fastest-growing Medicare brokerages in the nation. The position reports directly to the Head of Legal & Compliance. - Oversee the Quality Assurance (QA) program across a Medicare inside sales organization. - Lead and manage a team of QA professionals. - Drive risk reduction through QA initiatives, leveraging artificial intelligence tools. - Utilize, audit, and monitor compliance with CMS requirements, including Medicare Advantage, Part D regulations, and Star Ratings measures. - Maintain audit readiness for CMS program audits, mock audits, and validation activities. - Maintain and develop our artificial intelligence platform to meet the changing needs of the business. - Develop and monitor QA metrics, driving the QA function through the use of an artificial intelligence platform. - Manage data validation processes and ensure timeliness and accuracy in reporting. - Collaborate with Compliance, Operations, and Sales teams to align QA efforts with organizational goals. - Maintain QA training, monitoring, and auditing policies and processes to ensure compliance with applicable policies, procedures, and regulatory requirements. - Coordinate with TPMOs and carriers regarding QA metrics and reporting. - Partner with the Your Way Insurance leadership team to strategize on risk mitigation and monitor compliance metrics effectively. Qualifications - Bachelor’s degree (Master’s or JD preferred) in healthcare, business, or related field. - 7–10+ years in Medicare/managed care QA, with 5+ in leadership. - A proven track record of people management. - Deep knowledge of CMS regulations, HPMS, and Medicare audit protocols. - Data analytics capabilities (SQL, Tableau, PowerBI, Smartsheet); fluency with Artificial Intelligence, root cause analysis, vendor oversight experience, and people leadership. - Developed sense of business judgment obtained via a minimum of 7 to 10+ years of experience working with a compliance program within a highly regulated industry. - Strong communication skills, such as executive presentation and reporting. - Experience with HEDIS, Stars, and CAHPS is a plus. - Certifications like CHC, CPHQ, or Six Sigma are valuable. Benefits - Medical/dental/vision plans, which start from day one! - Life and accident insurance. - 401(K) and Roth options. - Tax-advantaged accounts (HSA, FSA). - Educational expense reimbursement. - Paid parental leave. - Digital mental health services (Talkspace). - Flexible work hours (availability varies by office and job function). - Training programs. - Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing. - Charitable matching gift program. - And more...

• Complete a 30-minute online survey about your experience with AI agents • Describe the specific automated workflows you have built or configured recently • Share insights on your tooling choices and implementation strategies • Provide feedback on the effectiveness of your current AI tech stack

• Workflow Integration: Develop and implement strategies to integrate AI solutions into the existing SDLC, aiming to optimize operations and improve customer experience, recommending enhancements. • Needs Analysis: Collaborate with stakeholders across departments to identify opportunities that can drive efficiency and innovation. • Project Management: Lead the project to build the proposed platform from conception through execution, ensuring objectives are met on schedule and within budget while following appropriate prioritization. • Requirements Management: Translate business needs into features/user stories, turning scope into an organized, broken-down backlog ready for implementation. • Team Enablement: Deliver training and workshops on the implemented pipeline to teams, ensuring all employees are prepared to use the workflow/process. • Performance Measurement: Define success metrics for the pipeline and evaluate the impact of implemented solutions, adjusting strategies as needed to maximize return on investment. • Cross-Functional Collaboration: Facilitate communication and collaboration between technology, operations, and business teams to ensure effective integration throughout the project lifecycle.

• Own project management, change management and communications for AI rollouts across CHAI, including enterprise-wide tool procurement and rollout coordination. • Build demand for AI adoption across the organization: coordinate the AI Champion network, launch the Community of Practice, and maintain the AI@CHAI inbox for ongoing staff questions. • Build and manage CHAI’s AI training and enablement programs: develop training resources, design learning journeys, coordinate vendor-led trainings, launch AI ethics and competency trainings, and run AI onboarding for new employees. • Develop and maintain AI governance frameworks, policies, and user guidance in coordination with the Innovation team and IT, covering best practices, use case libraries, ethics guidance, and AI standards. • Coordinate the AI advisory committee and make sure it functions as an effective governance and decision-making body. • Define and track adoption metrics and targets, conduct quarterly gap and themes analysis, and assess ROI on AI tool usage (time saved vs. tooling cost).