QUALITY ASSURANCE AUDITOR, SPECIALIST - Blue Shield of California : Job Details

Job DescriptionYour RoleThe Pharmacy Quality Assurance, Specialist under direction of the Sr. Manager of Pharmacy Infrastructure is responsible for supporting a continuous quality assurance program. This role routinely audits the quality of the Pharmacy Authorization Contact Center technician team interactions with BSC internal and external customers. This role also identifies training opportunities and workflow gaps; assisting in the development and updating of new and existing work processes to support team achievement of required quality standards.Your WorkIn this role, you will:

• Responsible for performing assigned audits
• Focus on multiple areas of expertise or lines of business, and job functions (i.e. Call Center, Intake, Fax, UMRx)
• Identifies and documents audit observations and findings
• May review lower-level employee work
• Communicates audit issues and provides potential solutions
• Outlines communications to operations when necessary
• May participate in corrective/preventive action planning & implementation related to audits
• Interacts with operation representatives to influence outcomes
• Manages timelines, assignments, and work plans
• May represent BSC with internal partners and/or external entities
• Other duties as assigned
• Works to achieve operational targets within job area which has some impact on the overall achievement of broader team results
• Works independently with minimal supervision
• Work typically consists of tasks that are not routine, that require some discretion within broad operational boundaries and procedures
• Operational targets may be achieved through leading other team members within the job area through delegation and review or through individual execution
• Responsible for adjusting or recommending enhancements in systems and processes to solve problems or improve effectiveness of job area
• Communicates with contacts typically within and outside the department on matters that involve obtaining or providing information on matters of significant importance to the job area
• Explains practices, procedures and policies to reach agreement
• May act as a team lead and assistant to the supervisor/manager. May delegate tasks to other team members and be responsible for the review of work product
• May provide input to management in (e.g., performance management, disciplining, etc.)

QualificationsYour Knowledge and Experience

• Requires minimum of 7 years of experience.
• May require vocational or technical education in addition to prior work experience
• Requires a minimum of 1 year experience in a Call Center environment
• Requires previous quality assurance experience, performance coaching or other leadership experience e.g. providing feedback and coaching or training to less skilled or less experienced personnel preferred
• Requires advanced knowledge of automated systems in a production or operations environment
• Requires the ability to identify and resolve complex problems related to automated systems and operations within functional areas
• Requires demonstrated ability to follow issues through to resolution using time management skills and prioritization of workload
• Requires problem-solving skills
• Requires excellent interpersonal and verbal/written communication skills
• Requires ability to work independently with limited supervision using established procedures
• Requires strong computer skills to operate effectively with company systems and programs knowledge of Microsoft office (Word, PowerPoint, Visio & Excel)
• Requires strong documentation and organizational skills

Pay Range:The pay range for this role is: $ 24.48 to $ 34.27 for California.Note:Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.#LI-MM4About the TeamBlue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California's top companies in volunteering and giving. Here at Blue Shield, we strive to make a positive change across our industry and communities - join us!Our Values:

• Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
• Human. We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.
• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model:Blue Shield of California is dedicated to making work-life balance a reality. Whether you prefer to work in an office or from home, we understand flexibility is more important than ever. That's why Blue Shield is a hybrid company, offering you the opportunity to decide where you can do your best and most meaningful work.Two ways of working: Hybrid (our default) and office

• Hybrid - In a business unit approved office a few times per year to 3 days per week, on average

• Office - In a business unit approved office 4+ days a week, on average. If the role you're applying for is deemed an Essential Role, the company has determined that the role can only be performed in a Blue Shield office or in the field and would require your to meet the office worker classification.

Physical Requirements: Office Environment - roles involving part to full time schedule in Office Environment. Due to the current public health emergency in California, Blue Shield employees are almost all working remotely. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.Please click here for further physical requirement detail. Equal Employment Opportunity: External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.