Quality Specialist II

🔥 0 minutes ago

🐻 Alaska, Arizona, +25 more states – Remote

🐻 Alaska – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🌶️ New Mexico – Remote 🌲 North Carolina – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🏰 Missouri – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote ☕ Washington – Remote 🧀 Wisconsin – Remote

💵 $48.4k - $72.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Premera Blue Cross

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1945

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Premera Blue Cross is an independent health insurance provider, serving businesses and residents of Washington State and Alaska as a licensee of the Blue Cross Blue Shield Association. The company offers a range of health plans including individual, family, employer-based, and Medicare Supplement plans. However, it has announced that it will exit the Medicare Advantage market as of January 1, 2025. Premera is committed to advancing health equity and community support, evident through its Social Impact Program focused on behavioral health and homelessness solutions in Washington and Alaska. Additionally, Premera complies with federal and state civil rights laws, offering language assistance services to ensure equitable care.

📋 Description

• Conduct audits using and interpreting applicable standards and requirements • Plan, develop, and communicate audits within a defined scope, including resource scheduling • Conduct meetings required for audit performance • Maintain working knowledge of procedural changes, audit techniques, automated systems, subsystems, and reference materials • Verify, document, and communicate audit results • Develop audit reports and evaluate corrective actions and follow-up • Resolve audit findings and conflicts directly and respectfully • Identify trends and root causes of errors • Recommend improved procedures and guidelines to Operations • Consult with external departments on high-impact quality assurance issues • Participate in, lead, and facilitate team meetings and work groups concerning Quality Review & Reporting initiatives and incentives • Explain quality principles and align the audit function with organizational objectives • Perform other duties as assigned

🎯 Requirements

• High school diploma or GED (Required) • Three (3) years of claims, customer service or enrollment work experience, including one (1) year of quality audit, quality control, or quality assurance experience (Required) • Bilingual proficiency in a particular language (English/Spanish) may be required (Preferred) • Quality 101 certification (Preferred) • Ability to keyboard • Ability to communicate clearly and understandably in person and over the telephone • Ability to perform essential physical requirements with or without accommodation

🏖️ Benefits

• Medical, vision, and dental coverage with low employee premiums • Voluntary benefit offerings, including pet insurance • Life and disability insurance • Retirement programs, including a 401K employer match and a pension plan vested after 3 years of service • Wellness incentives, including mental well-being resources, counseling services, stress management programs, and mindfulness programs • Generous paid time off • Tuition assistance for undergraduate and graduate degrees • Employee recognition program • Commuter perks • Free convenient on-site parking • Subsidized on-campus cafes • On-site health and wellness activities • Fitness and well-being center with in-person and virtual workouts and nutritional counseling • Shuffleboard and ping pong on campus