Remote Quality Auditor II - Impactful QA & Compliance

Premera Blue Cross; Tallahassee (FL); Remote; USD 42,000 - 64,000; Full time

Job summary

Premera Blue Cross is seeking a Quality Audit professional to conduct audits and ensure adherence to standards. You will plan and communicate audit activities, maintain up-to-date knowledge of audit techniques, and document results with recommended corrective actions.

The role emphasizes identifying trends and root causes, coordinating with multiple departments, and leading quality review initiatives to improve processes.

Qualifications

• Three years of claims, customer service or enrollment work experience, including one year of quality audit/quality assurance.
• Bilingual proficiency in English/Spanish preferred.
• Quality 101 certification preferred.

Responsibilities

• Conduct audits in a professional, ethical and objective manner.
• Plan, develop, and communicate audits within defined scope and schedule meetings.
• Maintain knowledge of procedural changes and audit techniques.
• Verify, document and communicate audit results and follow-up actions.
• Identify trends and root causes, recommending improved procedures.
• Consult with external departments to resolve high-impact quality issues.
• Lead and facilitate team meetings related to Quality Review & Reporting initiatives.

Skills

Quality auditing

Data analysis

Root-cause problem-solving

Education

High school diploma or GED

Job description

Premera Blue Cross is seeking a Quality Audit professional to conduct audits and ensure adherence to standards. You will plan and communicate audit activities, maintain up-to-date knowledge of audit techniques, and document results with recommended corrective actions.

The role emphasizes identifying trends and root causes, coordinating with multiple departments, and leading quality review initiatives to improve processes.