Clinical Quality & Accreditation Operations Associate

Blue Cross Blue Shield of Kansas; Topeka (KS); Hybrid; USD 32,000 - 41,000; Full time

Benefits offered by this job

Incentive pay program (EPIP)

Health/Vision/Dental insurance

6 weeks paid parental leave

Fertility/Adoption assistance

2 weeks paid caregiver leave

401(k) plan matching up to 5%

Tuition reimbursement

Health & fitness benefits

Job summary

Blue Cross and Blue Shield of Kansas is seeking a Clinical Quality & Accreditation Associate to support reporting, monitoring, and improvement across clinical quality programs. This role helps ensure accuracy, timeliness, and regulatory alignment of quality data and initiatives.

You will coordinate data collection, validation, and submission for HEDIS, accreditation, and value-based measures, and provide administrative support to sustain program operations.

Qualifications

• Knowledge of clinical quality, accreditation, and value-based programs such as HEDIS.
• Ability to collect, validate, analyze, and submit data with attention to accuracy and deadlines.
• Strong organizational skills to manage documentation and tracking tools.
• Detail-oriented communication and proficiency with standard business software.

Responsibilities

• Support clinical quality reporting and improvement initiatives, including HEDIS, accreditation, value-based programs, and internal measures.
• Collect, validate, analyze, and submit quality, enrollment, cost, and population risk data and reports.
• Monitor quality performance, identify trends and gaps, and maintain program documentation.
• Provide administrative support for meetings, documentation, logistics, and databases.
• Track action items and deliverables; assist with reports and cross-coverage during peak periods.

Skills

HEDIS knowledge

Clinical quality

Data analysis

Regulatory reporting

Documentation management

Education

Bachelor's degree preferred

High school diploma required

Tools

Healthcare reporting systems

Microsoft Office

Job description

Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas.

Why Join Us?

• Make a Positive Impact: Your work will directly contribute to the health and well-being of Kansans.
• Family Comes First: Total rewards package that promotes the idea of family first for all employees. Paid vacation and sick leave with paid maternity and paternity available immediately upon hire
• Professional Growth Opportunities: Advance your career with ongoing training and development programs.
• Dynamic Work Environment: Collaborate with a team of passionate and driven individuals in a work environment that promotes flexibility.
• Trust and Stability: Work for one of the most trusted companies in Kansas with over 80 years of commitment, compassion and community.
• Inclusive Work Environment: We pride ourselves on fostering a workplace where everyone is valued and respected.

Benefits & Perks

• Base compensation is only one component of your competitive Total Rewards package
• Incentive pay program (EPIP)
• Health/Vision/Dental insurance
• 6 weeks paid parental leave for new mothers and fathers
• Fertility/Adoption assistance
• 2 weeks paid caregiver leave
• 401(k) plan matching up to 5%
• Tuition reimbursement
• Health & fitness benefits, discounts and resources

Job Summary

The Clinical Quality & Accreditation Associate supports clinical quality reporting, monitoring, and improvement activities across clinical quality programs. This role supports the development, implementation, and monitoring of clinical quality initiatives to improve healthcare outcomes, regulatory compliance, and performance metrics. The role contributes to the accuracy, timeliness, and organization of quality data, reporting processes, and program operations to support regulatory requirements, accreditation standards, and internal quality improvement initiatives. This role also provides essential administrative and operational support to ensure continuity, efficiency, and accuracy within clinical quality programs.

"This position is eligible to work remote, hybrid or onsite in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment."

What you'll do

• Support clinical quality reporting and improvement initiatives, including HEDIS, accreditation, value-based programs, and internal measures, ensuring alignment with regulatory and organizational requirements.
• Collect, validate, analyze, and submit quality, enrollment, cost, and population risk data and reports, ensuring accuracy, compliance, and timely delivery.
• Monitor quality performance, identify trends and gaps, and develop, organize, and maintain program and process documentation in a centralized repository.
• Provide administrative and operational support for clinical quality programs, including meeting coordination, documentation management, logistics, and maintenance of electronic files, shared resources, and databases.
• Track action items, deadlines, and deliverables; assist with reports, presentations, communications, and provide cross-coverage and backup support across lines of business during peak workloads or absences.

What you need

• Knowledge of clinical quality, accreditation, and value-based programs (including HEDIS and internal measures) with the ability to support compliant, timely reporting and improvement initiatives.
• Ability to collect, validate, analyze, and submit quality, enrollment, cost, and population risk data with strong attention to accuracy, deadlines, and regulatory requirements.
• Strong organizational skills with the ability to manage documentation, maintain tracking tools, and ensure accuracy, consistency, and timely updates across clinical quality programs
• Strong attention to detail, data accuracy, and communication skills required
• Proficiency with operating systems and standard business software and healthcare reporting systems required.
• Able to manage priorities and meet deadlines in a changing environment required.

Education and Experience

• High school diploma required; bachelor's degree preferred
• Experience in healthcare quality, reporting, or administrative support across multiple lines of business required
• Experience with clinical quality measures, regulatory reporting, audits, and quality improvement activities (e.g., HEDIS, CMS, NCQA) required

Physical Requirements

Ability to stand or sit for extended periods. Ability to look at a computer screen for prolonged periods. Occasional walking, bending, or reaching within the office environment. Ability to lift and carry up to 15 pounds. Ability to bend, kneel, stoop, or reach.

Compensation

$23.58 - 29.48 hourly

Non - Exempt Grade 12

Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts.

Our Commitment to Connection and Belonging

At Blue Cross and Blue Shield of Kansas, we are committed to fostering a culture of connection and belonging, where mutual respect is at the foundation of our workplace. We provide equal employment opportunities to all individuals, regardless of race, color, religion, belief, sex, pregnancy (including childbirth, lactation, and related medical conditions), national origin, age, physical or mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military or veteran status, family or parental status, or any other characteristic protected by applicable law.

Blue Cross and Blue Shield of Kansas conducts pre-employment drug screening, criminal conviction check, employment verifications and education as part of a conditional offer of employment.