Quality & Compliance Audit Specialist

Blue Shield of CA; San Diego (CA); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Blue Shield of CA is seeking an Operational Quality Auditor to perform production and quality control audits, ensuring adherence to specifications and quality standards. You will identify performance deficiencies, analyze trends, and propose systemic corrective actions.

The role reports to the Operational Quality Services Supervisor and emphasizes leadership development within a collaborative, growth-focused team.

Qualifications

• 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

• Performs production and quality control audits to measure performance and adherence to specifications
• Conducts comprehensive quality reviews to identify performance deficiencies and root causes
• Uses quality analysis tools to identify trends and systemic corrective actions
• Creates management reporting for leadership review and follow-up

Education

Bachelor's degree or High School Diploma/GED with 4 years of relevant experience

Job description

Blue Shield of CA is seeking an Operational Quality Auditor to perform production and quality control audits, ensuring adherence to specifications and quality standards. You will identify performance deficiencies, analyze trends, and propose systemic corrective actions.

The role reports to the Operational Quality Services Supervisor and emphasizes leadership development within a collaborative, growth-focused team.