Quality Specialist III

About the role

Premera Blue Cross is looking for a Quality Specialist III to help strengthen member experience, support compliance, and improve the quality of service across the organization. This role focuses on advanced auditing, training, process improvement, and cross-functional consultation. The position is classified as a telecommuter role.

In this position, you will act as a technical expert in a wide range of audit activities, including corporate audit programs such as the Blue Cross Blue Shield Association Local Operations Scorecard, Licensee Desk Level Audit, and Federal Employee Program audits. You will also provide tier II support to customer service representatives and QA teams both offshore and onshore, while helping ensure alignment with state and federal laws, contractual obligations, and company objectives.

You will also support the Quality Review & Reporting team by improving tools, procedures, training, and audit readiness. The role includes evaluating business and legal/compliance documents, leading calibration meetings, recommending training for new or updated systems and methods, and advising other teams on quality and continuous improvement opportunities.

Key responsibilities

• Organize and deliver training for all Quality Specialists on audit tools, processes, and procedures.
• Perform complex audits and determine whether findings meet BCBSA, FEP, state, and federal audit standards.
• Handle second-level support for escalated issues and audit outcomes.
• Partner with team members, OCLD, and managers to find training gaps and business needs, then help implement solutions.
• Review trainee audits and provide feedback on learning progress.
• Serve as a consultant to other departments in solving high-impact issues through quality assurance action plans.
• Support the Data Reporting Analyst by gathering data and preparing analyses for department and cross-functional needs.
• Promote a training and auditing environment that values diverse perspectives and team strengths.
• Assist with external audits and lead special projects.
• Take on additional duties as assigned.

Experience and qualifications

The ideal candidate should have at least 4 years of experience in customer service, claims, or membership and billing within a call center, healthcare, or insurance setting. In addition, 2 years of experience in training or audit-related work is required, along with familiarity with operational procedures.

Applicants should also have completed internal or external training in areas such as facilitation, conflict management, or handling difficult conversations. A quality-related certification such as CQA, CQIA, or CQPA is valued. A bachelor’s degree is preferred, though four years of relevant experience may be accepted in place of the degree.

What you will gain

This role offers the opportunity to deepen expertise in auditing, strengthen training and development capabilities, contribute to process improvement work, build data analysis skills, and expand cross-functional collaboration experience.

Physical requirements

This is primarily a sedentary role. It requires the ability to occasionally lift, carry, push, pull, or otherwise move objects up to 10 lbs. The job also requires keyboarding and clear communication in person and by telephone.

Compensation and benefits

The salary for this role is based on experience, location, market conditions, and skills. The national salary range is $52,400 to $78,600, and the national plus salary range is $59,800 to $89,700 for higher-cost labor markets such as Western Washington and Alaska. Compensation can be discussed further during the interview.

Premera offers a broad total rewards package that includes medical, vision, and dental coverage with low employee premiums; voluntary benefits such as pet insurance; life and disability coverage; retirement benefits including a 401(k) match and pension plan vested after 3 years; wellness incentives and mental well-being resources; generous paid time off; tuition assistance for undergraduate and graduate studies; and an employee recognition program.

For hybrid employees, the campus model includes flexible routines, access to onsite resources, networking opportunities, and team engagement. Additional onsite benefits include commuter perks, free parking, subsidized cafes, wellness events, a fitness and well-being center with in-person and virtual workouts plus nutritional counseling, and recreational options such as shuffleboard and ping pong.

Equal opportunity and application support

Premera Blue Cross is an equal opportunity and affirmative action employer. Hiring is open in multiple states, including Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, and Wisconsin, with some location-based restrictions depending on the role or city.

If accommodation is needed for the online application process, candidates may contact Premera Human Resources at careers@premera.com or 425-918-4785.

Additional information

The role is expected to support compliance with corporate audit programs, state and federal requirements, contracts, and internal quality objectives. Premera emphasizes collaboration, continuous development, innovation, and purpose-driven work as part of its workplace culture.