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Premera Blue Cross · 11 hours ago

Quality Specialist III

United States

Full-time

Onsite

Mid Level

$52K/yr - $79K/yr

4+ years exp

Premera Blue Cross is committed to improving healthcare and enhancing customer experiences. As a Quality Specialist III, you will ensure compliance with audit programs and quality standards while leading training initiatives to foster a culture of continuous improvement.

Cyber SecurityHealth CareInformation TechnologyInsurance

H1B Sponsor Likely

Responsibilities

Lead and organize training for all Quality Specialists on audit processes, procedures, and tools

Conduct complex audits and verifying quality standards for selected inquiries and make decisions whether discrepant information meets BCBSA and FEP audit requirements, state, and federal mandates

Provide second-level support on escalated issues and audit findings

Collaborate with team members, OCLD, and management to identify training gaps and business needs and implement actions while partnering to address these issues

Review, evaluate, and provide feedback on trainees’ audits and learning processes

Act as a consultant with external departments to help resolve high-impact business issues by recommending action plans related to quality assurance

Assist the Data Reporting Analyst in collecting data and providing analyses for various issues across the department and other functional areas

Foster a training and auditing culture that values diversity of thought, leveraging team member strengths to achieve team goals

Assist with external audits and lead special projects

Perform other duties as assigned

Qualification

Audit expertiseTraining experienceQuality certificationData analysisOperational proceduresCollaborationCommunicationProblem-solving

Required

Four (4) years of customer service, claims or membership and billing experience in a call center, healthcare, or insurance environment (Required)

Two (2) years of experience in training or audit functions (Required)

Experience with operational procedures (Required)

Completion of internal or external courses dealing with facilitation skills, conflict management, dealing with difficult people, etc

Quality certification such as Certified Quality Auditor (CQA), Quality Improvement Associate (CQIA), Quality Process Analyst Certification (CQPA)

Bachelor's Degree or four years related experience

Benefits

Medical, vision, and dental coverage with low employee premiums.

Voluntary benefit offerings, including pet insurance for paw parents.

Life and disability insurance.

Retirement programs, including a 401K employer match and, believe it or not, a pension plan that is vested after 3 years of service.

Wellness incentives with a wide range of mental well-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to name a few.

Generous paid time off to reenergize.

Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees.

Employee recognition program to celebrate anniversaries, team accomplishments, and more.

Commuter perks make your trip to work less impactful on the environment and your wallet.

Free convenient on-site parking.

Subsidized on-campus cafes make lunchtime connections with colleagues fun and affordable.

Participate in engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more.

Our complementary fitness & well-being center offers both in-person and virtual workouts and nutritional counseling.

Company

Premera Blue Cross

Glassdoor3.2

Premera is a leading health plan in the Pacific Northwest, providing comprehensive health benefits and tailored services.

Founded in 1945

Mountlake Terrace, Washington, USA

1001-5000 employees

https://www.premera.com

H1B Sponsorship

Premera Blue Cross has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (21)

2024 (29)

2023 (13)

2022 (25)

2021 (15)

2020 (5)