Job details
Job type full-time
Full job description
The quality assurance team drives organizational success by collaborating with all areas of the organization to engaging in activities designed to research, analyze and provide swift actionable feedback to support business areas in sustaining or improving the total experience for capital bluecross members.
The quality assurance specialist will work as part of a team collaborating with all levels across the department and companyThis individual will contribute to the team’s success by gathering and analyzing data and communicating audit results to staff, supervisors and managementThis position is critical in reviewing and evaluating adherence to policies, regulations and ensuring a high level of member satisfaction via the audit criteria set forthThey will also provide detailed analysis, trends and feedback as it relates to audit results to drive process improvements across the department and company.
Under general direction, responsible for advanced level detailed auditing of any departments, individuals, products, systems, data, etcThat fall within designated training/abilities.
Analyzes and interprets policies, documents, procedures, data and actions to accurately assess member impact and communicate any roadblocks or impacts to management.
Updates audit results and findings are reported to staff, supervisors and management.
Independently research and gather supporting documentation related to audits as well as submitting documentation to other departments
Summarize verbally and in writing advanced research or explanation of processes as well as modify communication so that it is understandable to the intended audience.
Complete tasks with a high level of speed and accuracy in order to meet processing deadlines.
Ability to multitask and strong attention to detail
Responsible for accuracy of audit findings
Maintains knowledge of regulations, processes, procedures and expectations for audits that are performed
Analyze root cause of results and/or trends from the audits to improve policies, procedures or automated processing to enhance the member experience.
Independently research and gather supporting documentation via various sources to support the auditing process
Keep up to date on various internal policies, system changes, updates, communication, etc.
Completes special requests and routine assignments for management, supervisor and lead when necessary
Serve/actively participate, provide research and analysis, assistance and miscellaneous support on internal/external department projects.
Act as subject matter expert across 1 or more departments.
Identifies individual and department training gaps
Assists with specialized training within the department.
Function as a back-up for lead responsibilities
Leadership:
Ability and willingness to mentor department staff and assist with internal training
Knowledge :
Requires thorough knowledge of core business applicationsMust have basic knowledge in operating a pc and using various software programs.
Skills:
Function as a high performing team member
Demonstrate strong organizational, research and analytical problem solving skills
Ability to modify communication so that it is clear and concise to the intended audience, both verbally and in writing
Independently prioritize and complete work assignments within set deadlines
Resilient and adaptable to changing business needs
Ability to maintain strict confidentiality
Ability to multitask and strong attention to detail
Experience:
5+ years of experience at cbc
Prior experience in operations department preferred
Education, certification, and licenses:
Must have a high school diploma or ged
Work environment:
Office or wah
Travel requirements: 0%
Amount (% of time)
Physical demands:
While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see.
The employee must be able to work over 40 hours per week during peak business timesThe employee must occasionally lift and/or move up to 5 pounds
Capital bluecross is an independent licensee of the bluecross blueshield associationWe are an equal opportunity/affirmative action employer and do not discriminate on the basis of race, color, religion, national origin, gender, sexual orientation, gender identity, age, genetic information, physical or mental disability, veteran status, or marital status, or any other status protected by applicable law.
