Remote Clinical Quality & Compliance Analyst

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

Benefits offered by this job

Medical, dental, and vision coverage

Parental leave & adoption support

Tuition reimbursement

401k match

Paid time off

Job summary

Blue Cross NC is hiring a Clinical Quality Management Analyst to evaluate, analyze, and monitor staff or provider performance. The role supports learning solutions and drives continuous improvement through data-driven insights and action plans.

You will work in a Remote Flex environment across the US, collaborating with the Clinical Quality Reporting & Compliance Team to ensure regulatory alignment and high-quality care outcomes.

Qualifications

• RN or LPN with required years of clinical experience.
• Bachelor's or higher preferred for advanced roles.
• Strong analytical and communication skills.

Responsibilities

• Conduct quality audits of staff and providers to ensure compliance with policies and procedures.
• Develop learning solutions based on audit findings and performance gaps.
• Monitor and report performance results including benchmarking and trends.
• Assist with vendor relationships and data elements changes (Ellkay/CDX).

Skills

RN with 3 years clinical

LPN with 5 years clinical

Education

Bachelor's degree

Advanced degree

Job description

Blue Cross NC is hiring a Clinical Quality Management Analyst to evaluate, analyze, and monitor staff or provider performance. The role supports learning solutions and drives continuous improvement through data-driven insights and action plans.

You will work in a Remote Flex environment across the US, collaborating with the Clinical Quality Reporting & Compliance Team to ensure regulatory alignment and high-quality care outcomes.