Quality Analyst Associate

Company Name:
Blue Cross Blue Shield of North Carolina
Major Responsibilities
Performs quality audits of operational procedures and inquiries received from internal and external customers. Provides cross-functional support for operational functions, which may include one-on-one coaching and feedback, trending, or root cause analysis. Provides objective feedback and recommends corrective actions and process improvements resulting in improved quality of customer service, and improved efficiency and effectiveness of operations.
Performs quality reviews of departmental operation activities to determine the accuracy of established process and procedures.
Ensures corrective actions are implemented to increase accuracy.
Analyzes quality review results at the individual and team level, identifies trends and make recommendations to improve quality
Provides face-to-face and/or written feedback and coaching regarding quality review results to help improve individual and overall performance
Enters results of reviews into appropriate quality database
Identifies issues identified via quality results or trend analysis needing further investigation and raises issues to proper management
Identifies and communicates to manager potential compliance and enterprise risk issues.
Researches and provides information and resources that will allow accurate processing, data entry, and resolution of issues
Participates in the development and revision of business processes and procedures.
High School Diploma or GED and 2 years operations processing using PowerMHS, MAGIC and Blue Quote, with high quality scores
Additional Critical Skills & Knowledge Needed for Job
Beginning level proficiency in use of Microsoft Word, PowerPoint, and Excel
Ability to demonstrate an appreciation of diversity and differences by modeling an open-minded approach to and respect for customers from different cultures
Ability to demonstrate effective verbal and written communication skills
Skilled at using active listening skills and providing constructive feedback
Demonstrated ability to develop job aids and/or coaching materials targeting 1-3 issues
Ability to utilize quality improvement tools to perform root cause analysis and identify data trends in simple to moderately complex issues
AutoReqId: 11907BR
Job Title: Quality Analyst Associate
Business Function: Service & Support
Department: SMA Support Services
Position Location: Winston Salem

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