Remote Clinical Quality Analyst – HEDIS & Compliance

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

Benefits offered by this job

Medical/Dental/Vision coverage

Parental leave

Tuition reimbursement

401k match

Job summary

Blue Cross NC is seeking a Clinical Quality Management Analyst to join the Clinical Quality Reporting & Compliance Team. You will evaluate staff and provider performance, provide actionable feedback, and develop learning solutions to close quality gaps.

You will conduct quality audits to ensure regulatory and policy compliance, support learning design, and monitor performance with benchmarking and trends. Remote-flex role with nationwide reach in the United States.

Qualifications

• RN with 3+ years clinical experience in quality or care delivery is preferred.
• LPN with 5+ years clinical experience in quality programs is valued.
• Bachelor's or advanced degree in a related field is preferred.

Responsibilities

• Conduct quality audits of staff and providers to ensure compliance with policies and regulations.
• Provide guidance and feedback with action plans to address deficiencies.
• Analyze performance data, benchmark trends, and identify opportunities for improvement.
• Design learning solutions based on audit findings and staff needs.

Skills

RN with 3 years

LPN with 5 years

Education

Bachelor's degree or advanced degree

Job description

Blue Cross NC is seeking a Clinical Quality Management Analyst to join the Clinical Quality Reporting & Compliance Team. You will evaluate staff and provider performance, provide actionable feedback, and develop learning solutions to close quality gaps.

You will conduct quality audits to ensure regulatory and policy compliance, support learning design, and monitor performance with benchmarking and trends. Remote-flex role with nationwide reach in the United States.