Hybrid Operational Quality Auditor

Blue Shield of CA; Rancho Cordova (CA); Hybrid; USD 70,000 - 100,000; Full time

Job summary

Blue Shield of CA is seeking an Operational Quality Services Auditor to perform production and quality control audits, ensuring adherence to specifications and quality standards. The role reports to the Operational Quality Services Supervisor and involves identifying performance deficiencies and creating management reporting for follow-up.

The position supports a hybrid workplace, requiring in-office presence two days per week, with flexibility based on business needs.

Qualifications

• Bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree.
• Knowledge in health care compliance, legislative or legal services, healthcare, privacy, audit or investigative services preferred.
• Practical knowledge of production and quality control audits typically obtained through advanced education combined with experience.
• Knowledge and experience with claims processing preferred.

Responsibilities

• Perform production and quality control audits to measure performance.
• Assure adherence to established specifications and quality standards.
• Conduct comprehensive quality reviews to identify performance deficiencies.
• Use quality analysis tools to analyze trends, root causes and identify systemic corrective action opportunities.
• Create management reporting for review and follow up.

Education

Bachelor's degree

High School Diploma/GED and 4 years of additional relevant experience

Job description

Blue Shield of CA is seeking an Operational Quality Services Auditor to perform production and quality control audits, ensuring adherence to specifications and quality standards. The role reports to the Operational Quality Services Supervisor and involves identifying performance deficiencies and creating management reporting for follow-up.

The position supports a hybrid workplace, requiring in-office presence two days per week, with flexibility based on business needs.