Remote Clinical Quality Analyst — Audits & Improvement

Blue Cross and Blue Shield of North Carolina; Maryland; Remote; USD 74,000 - 118,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Wellness programs

Parental leave and surrogacy support

Tuition reimbursement

401k match

Job summary

Blue Cross NC is seeking a Clinical Quality Management Analyst to join the Clinical Quality Reporting & Compliance Team. This role evaluates and monitors staff and provider performance, delivering actionable feedback and plans to close gaps in quality and compliance.

You will design learning solutions from audit findings, analyze performance trends, and support data-driven decisions. Remote-flex role with potential in-office visits; collaboration with management to drive continuous improvement.

Qualifications

• Experience conducting quality audits of staff and providers.
• Background in interpreting clinical guidelines and regulatory requirements.
• Strong analytical, organizational and communication skills.

Responsibilities

• Conduct quality audits to ensure compliance with objectives, policies, and procedures.
• Develop learning solutions based on audit findings and performance gaps.
• Monitor, analyze, and report performance with benchmarking and trend analysis.
• Provide guidance on clinical decision-making and support workflow improvements.

Skills

RN 3+ years clinical experience

LPN 5+ years clinical experience

Education

Bachelor's degree or advanced degree preferred

Job description

Blue Cross NC is seeking a Clinical Quality Management Analyst to join the Clinical Quality Reporting & Compliance Team. This role evaluates and monitors staff and provider performance, delivering actionable feedback and plans to close gaps in quality and compliance.

You will design learning solutions from audit findings, analyze performance trends, and support data-driven decisions. Remote-flex role with potential in-office visits; collaboration with management to drive continuous improvement.