Join Our Team: Do Meaningful Work and Improve People’s Lives
Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.
Premera is committed to being a workplace where people feel empowered to grow, innovate, and lead with purpose. By investing in our employees and fostering a culture of collaboration and continuous development, we’re able to better serve our customers. It’s this commitment that has earned us recognition as one of the best companies to work for. Learn more about our recent awards and recognitions as a greatest workplace.
Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog: https://healthsource.premera.com/.
If you’re passionate about accuracy, continuous improvement, and making a measurable impact on how work gets done, this is your opportunity to step into the Provider Quality Specialist II role and influence quality outcomes across the organization. In this role, you won’t just review work—you’ll help shape standards, elevate performance, and partner with teams to drive meaningful improvements that support our business goals.
As a Quality Specialist II, you’ll build on your experience by applying critical thinking, audit expertise, and collaboration skills to strengthen processes, identify trends, and support both onshore and offshore teams. This is an ideal next step for someone who enjoys coaching, problem‑solving, and being a trusted quality resource while continuing to grow professionally within our organization.
The Quality Specialist II is responsible for overseeing Premera's compliance with corporate audit programs such as the Blue Cross Blue Shield Association (BCBSA) Member Touchpoint Measures (MTM) and Licensee Desk Level Audit (LDLA), the Federal Employee Program (FEP) audit and tier I support within customer service offshore and onshore teams, along with ensuring compliance with state and federal laws, contracts and the achievement of corporate objectives. The Quality Specialist II performs daily examination and verification of Premera transactions, such as claims processing, customer inquiries, group, member enrollment, electronic data exchange and daily examination and enrollment and electronic data exchange transactions. The Quality Specialist II monitors all quality standards for selected claims, inquiries, enrollments and/or electronic transactions for accuracy, completeness and timeliness to judge the degree of adherence to the criteria set forth by the BCBSA, FEP and corporate policy requirements. The Quality Specialist II will work in conjunction with stakeholders to identify opportunities for quality improvement throughout the company.
What you will do:
- Effectively plan, develop, and communicate an audit within a defined scope, including resource scheduling. Conduct necessary meetings in performance of the audit.
- Maintain in-depth working knowledge of procedural changes, audit techniques, and plan automated systems, subsystems, and reference materials for assigned audit functions.
- Responsible for a wide variety of quality auditing tools and techniques. Verify, document and communicate audit results, develop an audit report, and evaluate the effectiveness of corrective action/follow-up.
- Resolve conflict directly and respectfully, engaging in challenging and important conversations to resolve audit findings.
- Identify trends and the root cause of errors and recommend improved procedures/guidelines to Operations proactively.
- Assist in consulting with external departments to help resolve high impact key business issues surrounding quality assurance.
- Help individuals and the team become stronger by actively participating, leading and facilitating team meetings and workgroups regarding Quality Review & Reporting initiatives and incentives.
- Understand quality principles as they relate to business processes and explain the importance of aligning the audit function to the organization.
- Other duties as assigned.
What you will bring:
- High school diploma or GED (Required).
- Three (3) years of claims, customer service or enrollment work experience, which includes one (1) year of quality audit, quality control, or quality assurance experience (Required).
- Experience in operating computer in a Windows environment, including Visio, Access and Power point and Internet (DSHS, OIC regulations, HCFA, Public use files, etc.).
What you will gain:
Quality Influence & Coaching Presence
You’ll deepen your ability to influence outcomes without direct authority—using data, credibility, and thoughtful feedback to coach peers, support offshore and onshore partners, and elevate performance across teams. This skill shows growth in leadership presence, not just technical expertise.
Analytical Thinking & Pattern Recognition
Beyond reviewing individual transactions, you’ll strengthen your ability to spot trends across workstreams, connect root causes to upstream process gaps, and translate findings into clear, actionable insights that help the business improve proactively.
Business Communication & Stakeholder Partnership
You’ll continue building the skill of communicating complex quality findings in a way that resonates with different audiences—operations, leadership, and cross‑functional partners—helping drive alignment, trust, and informed decision‑making.
Change Agility & Process Improvement Mindset
As standards, systems, and policies evolve, you’ll sharpen your ability to adapt quickly, stay current, and help others navigate change—while contributing ideas that improve processes, reduce errors, and strengthen quality outcomes over time.
Professional Judgment & Quality Governance
You’ll further develop sound judgment in applying standards consistently and ethically, balancing accuracy, timeliness, and business impact. This includes knowing when to escalate issues, challenge assumptions, and advocate for quality principles with confidence.
Physical Requirements:
The following have been identified as essential physical requirements of this job and must be performed with or without an accommodation:
This is primarily a sedentary role, which requires the ability to exert up to 10 lbs. of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. This role requires the ability to keyboard and to communicate clearly and understandably in person, and over the telephone.
Premera total rewards
Our comprehensive total rewards package provides support, resources, and opportunities to help employees thrive and grow. Our total rewards are more than a collection of perks, they're a reflection of our commitment to your health and well-being. We offer a broad array of rewards including physical, financial, emotional, and community benefits, including:
- Medical, vision, and dental coverage with low employee premiums.
- Voluntary benefit offerings, including pet insurance for paw parents.
- Life and disability insurance.
- Retirement programs, including a 401K employer match and, believe it or not, a pension plan that is vested after 3 years of service.
- Wellness incentives with a wide range of mental well-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to name a few.
- Generous paid time off to reenergize.
- Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees.
- Employee recognition program to celebrate anniversaries, team accomplishments, and more.
For our hybrid employees, our on-campus model provides flexibility to create your own routine with access to on-site resources, networking opportunities, and team engagement.
- Commuter perks make your trip to work less impactful on the environment and your wallet.
- Free convenient on-site parking.
- Subsidized on-campus cafes make lunchtime connections with colleagues fun and affordable.
- Participate in engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more.
- Our complementary fitness & well-being center offers both in-person and virtual workouts and nutritional counseling.
- Need a brain break? Challenge someone to a game of shuffleboard or ping pong while on campus.
Equal employment opportunity/affirmative action:
Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.
If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at careers@premera.com or via phone at 425-918-4785.
Premera is hiring in the following states, with some limitations based on role or city: 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, Wisconsin.
The pay for this role will vary based on a range of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience.
The salary range for this role is posted below; we generally target up to and around the midpoint of the range.
National Salary Range:
$48,400.00 - $72,600.00
National Plus Salary Range:
$55,200.00 - $82,800.00
*National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska.
We’re happy to discuss compensation further during the interview because we believe that open communication leads to better outcomes for all. We’re committed to creating an environment where all employees are celebrated for their unique skills and contributions.
