Quality Operations Auditor (Hybrid)

Blue Shield of CA; Springfield Meadows (CA); Hybrid; USD 90,000 - 110,000; Full time

Job summary

Blue Shield of CA is seeking an Operational Quality Services Auditor to perform production and quality control audits to measure performance and ensure adherence to quality standards. You will identify performance deficiencies, analyze trends, and develop corrective actions, while creating management reports for leadership review.

The role supports a hybrid workplace model with in-office collaboration and periodic scheduling based on business needs.

Qualifications

• Bachelor's degree or High School Diploma/GED with 4 years of relevant experience.
• 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 and root causes and identify systemic corrective actions.
• Create management reporting for review and follow-up.

Skills

Quality audits

Data analysis

Documentation

Team collaboration

Education

Bachelor's degree or High School Diploma

Job description

Blue Shield of CA is seeking an Operational Quality Services Auditor to perform production and quality control audits to measure performance and ensure adherence to quality standards. You will identify performance deficiencies, analyze trends, and develop corrective actions, while creating management reports for leadership review.

The role supports a hybrid workplace model with in-office collaboration and periodic scheduling based on business needs.