Remote Quality Assurance Specialist II

Premera Blue Cross; Austin (TX); Remoto; USD 52.000 - 70.000; Tempo integral

Resumo da vaga

Premera Blue Cross in Austin, TX is seeking a quality audit professional to conduct audits, interpret standards, and help improve healthcare operations. This telecommuter role offers the chance to impact member experience while working remotely.

You will plan audits, maintain up-to-date knowledge of procedures, verify results, and prepare reports. Strong data analysis and root-cause skills are highly valued, and bilingual capabilities (English/Spanish) are a plus.

Qualificações

• Three (3) years of claims, customer service or enrollment work experience, including one year in quality audit/quality assurance.
• Bilingual English/Spanish ability preferred to articulate messages clearly.
• Quality 101 certification preferred.

Responsabilidades

• Conduct audits in a professional, ethical and objective manner using and interpreting applicable standards/requirements.
• Effectively plan, develop, and communicate an audit within a defined scope, including resource scheduling.
• Maintain in-depth working knowledge of procedural changes, audit techniques, and reference materials for assigned audit functions.
• Verify, document and communicate audit results, develop an audit report, and evaluate the effectiveness of corrective action/follow-up.
• Resolve conflict directly and respectfully, engaging in challenging and important conversations to resolve audit findings.
• Identify trends and the root cause of errors and recommend improved procedures/guidelines to Operations proactively.
• Assist in consulting with external departments to help resolve high impact key business issues surrounding quality assurance.
• Help individuals and the team become stronger by actively participating, leading and facilitating team meetings and work groups regarding Quality Review & Reporting initiatives and incentives.
• Understand quality principles as they relate to business processes and explain the importance of aligning the audit function to the organization.
• Other duties as assigned.

Conhecimentos

Quality auditing

Data analysis

Root-cause analysis

Formação

High school diploma or GED

Quality 101 certification

Descrição da vaga

Premera Blue Cross in Austin, TX is seeking a quality audit professional to conduct audits, interpret standards, and help improve healthcare operations. This telecommuter role offers the chance to impact member experience while working remotely.

You will plan audits, maintain up-to-date knowledge of procedures, verify results, and prepare reports. Strong data analysis and root-cause skills are highly valued, and bilingual capabilities (English/Spanish) are a plus.