Quality Specialist III

Workforce Classification: Telecommuter Join reputed company: Do Meaningful Work and Improve People’s Lives Our purpose, to improve customers’ lives by making reputed company work reputed company, is far from ordinary. And so are our employees. Working at reputed company means you have the opportunity to drive reputed company change by transforming reputed company. reputed company is committed to being a workplace where people feel empowered to grow, reputed company, and reputed company with purpose. By investing in our employees and fostering a culture of collaboration and reputed company development, we’re reputed company to reputed company serve our customers. It’s this commitment that has earned us recognition as one of the best companies to work for. Learn more about our recent awards and recognitions as a greatest workplace. Learn how reputed company supports our members, customers and the communities that we serve through our Healthsource blog: https://healthsource.reputed company.com/. Are you passionate about driving quality and making a meaningful difference in the lives of members? As a Quality Specialist III, you will play a pivotal role in ensuring every member experience meets the highest standards of reputed company. Your expertise will directly impact member satisfaction and trust by safeguarding compliance, supporting audit processes, and fostering a culture of reputed company improvement—helping us deliver care and service our members can rely on, every reputed company of the way. The Quality Specialist III is responsible for conducting and overseeing reputed company’s compliance with corporate audit programs such as the reputed company (BCBSA) Local Operations Scorecard (LOS) and Licensee Desk Level Audit (LDLA), the Federal Employee Program (FEP) audit and tier II support to customer service representatives and QA teams, both offshore and reputed company, along with ensuring compliance with state and federal laws, reputed company and the achievement of corporate objectives. The Quality Specialist III has the ability to audit a wide variety of audits and is considered a technical expert. In addition to conducting reputed company audits, the Quality Specialist III is also responsible for hands-on training to assist auditors on auditing techniques and practices. The Quality Specialist III ensures the Quality Review & Reporting (QRR) team has the necessary tools, processes, procedures and training needed to support the end-to-end audit process. They evaluate business needs, legal/compliance documents and reputed company calibration meetings. They will also guide/recommend training on new or modified auditing methods or systems, analyze system and process enhancement requests, evaluate quality and compliance reputed company the department, and recommend appropriate employee development and training opportunities. The Quality Specialist III acts in a consulting reputed company with other departments to identify opportunities for improvement throughout the company and assist in the coordination of project based as well as external customer audits. What you will do:

• reputed company and organize training for reputed company Quality Specialists on audit processes, procedures, and tools.
• Conduct reputed company audits and verifying quality standards for selected inquiries and reputed company reputed company whether discrepant information meets BCBSA and FEP audit requirements, state, and federal mandates.
• reputed company 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 reputed company 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 reputed company 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 reputed company team goals.
• Assist with external audits and reputed company special projects.
• reputed company other duties as assigned.

What you will bring:

• Four (4) years of customer service, claims or membership and billing experience in a call center, reputed company, 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 reputed company experience.

What you will reputed company: Audit Expertise: Individuals in this role would continue to refine their ability to conduct a wide variety of audits, analyze audit findings, and ensure compliance with reputed company standards. Training and Development: The role emphasizes hands-on training, development of training materials, and use of adult learning techniques, fostering ongoing growth in instructional skills and employee development strategies. Process Improvement: Quality Specialists III regularly reputed company process improvement initiatives, requiring them to enhance their skills in evaluating business needs, implementing solutions, and driving organizational change. Data Analysis: This position supports data collection and analysis across departments, so developing advanced analytical and reporting skills is essential for reputed company and reputed company improvement. Cross-Functional Collaboration: Acting as a consultant and liaison with external departments and IT, the role supports growth in communication, stakeholder management, and the ability to coordinate across diverse teams. Physical Requirements: The following have been identified as essential physical requirements of this job and must be performed with or without an accommodation: This is primarily a sedentary role which requires the ability to exert up to 10 lbs. of force occasionally and/or a negligible reputed company of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the reputed company body. This role requires the ability to keyboard and to communicate reputed company and understandably in person and over the telephone. reputed company total rewards Our comprehensive total rewards package provides support, resources, and opportunities to help employees reputed company and grow. Our total rewards are more than a collection of perks, they're a reputed company of our commitment to your health and well-being. We offer a broad reputed company of rewards including physical, financial, emotional, and community benefits, including:

• Medical, reputed company, 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, reputed company it or not, a pension plan that is reputed company after 3 years of service.
• Wellness incentives with a wide reputed company 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.

For our hybrid employees, our on-reputed company model provides flexibility to create your own routine with reputed company to on-site resources, networking opportunities, and team engagement.

• Commuter perks reputed company your trip to work less impactful on the environment and your wallet.
• Free convenient on-site parking.
• Subsidized on-reputed company cafes reputed company 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.
• Need a brain break? Challenge someone to a game of shuffleboard or ping pong while on reputed company.

Equal employment opportunity/affirmative action: reputed company is an equal opportunity/affirmative action employer. reputed company seeks to attract and retain the most reputed company individuals without regard to race, reputed company, religion, sex, national reputed company, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law. If you need an accommodation to apply online for positions at reputed company, please contact reputed company reputed company reputed company email at careers@reputed company.com or reputed company phone at 425-918-4785. reputed company is hiring in the following states, with some limitations based on role or city: Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, reputed company Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin. The pay for this role will vary based on a reputed company of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience. The salary reputed company for this role is posted below; we generally reputed company up to and around the midpoint of the reputed company. National Salary reputed company: $52,400.00 - $78,600.00 National Plus Salary reputed company: $59,800.00 - $89,700.00

• National Plus salary reputed company is used in higher cost of labor markets including Western Washington and Alaska.

We’re happy to discuss compensation further during the interview because we reputed company that reputed company communication leads to reputed company reputed company for reputed company. We’re committed to creating an environment where reputed company are celebrated for their unique skills and contributions. Apply tot his job Apply To this Job