Quality Assurance Auditor – Operations & Compliance

Blue Shield of CA; Lodi (CA); Hybrid; USD 78,000 - 120,000; Full time

Job summary

Blue Shield of CA is seeking an Operational Quality Services Auditor to perform production and quality control audits and measure performance in line with service levels.

Reports to the Operational Quality Services Supervisor and will identify deficiencies, analyze trends and root causes, and generate management reporting for action. This hybrid, in-office role emphasizes collaboration and continuous improvement across teams.

Qualifications

• Bachelor's degree or HS diploma with 4 years of relevant experience in lieu of a degree.
• Knowledge in healthcare compliance, legislative or legal services, healthcare, privacy, audit or investigative services preferred.
• Practical knowledge of production and quality control audits typically obtained through education and experience.
• Knowledge and experience with claims processing preferred.

Responsibilities

• Perform production and quality control audits to measure performance.
• Ensure adherence to established specifications and quality standards.
• Conduct comprehensive quality reviews to identify performance deficiencies.
• Use quality analysis tools to analyze trends and root causes and identify corrective actions.
• Create management reports for review and follow up.

Skills

Quality audits

Data analysis

Root cause analysis

Reporting

Healthcare compliance

Education

Bachelor's degree

High School Diploma/GED

Job description

Blue Shield of CA is seeking an Operational Quality Services Auditor to perform production and quality control audits and measure performance in line with service levels.

Reports to the Operational Quality Services Supervisor and will identify deficiencies, analyze trends and root causes, and generate management reporting for action. This hybrid, in-office role emphasizes collaboration and continuous improvement across teams.