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Operational Quality Services Specialist, Associate

Blue Shield of CA
United States, California, Oakland
601 12th Street (Show on map)
Oct 01, 2026

Your Role

The Operational Quality Services team conducts audits, documents quality issues and performance measures and conduct reviews of policies and procedures to ensure alignment with service level requirements. The Operational Quality Services Auditor will report to the Operational Quality Services Supervisor. In this role you will be responsible for performing production and quality control audits to measure performance. Assures adherence to established specifications and quality standards. Conducts comprehensive quality review to identify performance deficiencies. May use quality analysis tools to analyze trends, root causes and identify systemic corrective action opportunities. Creates management reporting for review and follow up. Other duties as assigned.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

  • Bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree required
  • Knowledge in health care compliance, legislative or legal services, healthcare, privacy, audit or investigative services preferred
  • Practical knowledge of production and quality control audits typically obtained through advanced education combined with experience preferred
  • Knowledge and experience with claims processing preferred

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.

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