Apply Disability Management expertise as a Quality Assurance Advisor at Pacific Blue Cross, working hybrid across office and home settings.
This experienced position moves beyond daily claims adjudication into independent reviews, audits, and compliance evaluations. You will assess disability claims practices, identify risks and trends, and recommend improvements. The work supports training, performance management, compliance, and continuous improvement across operations.
Key Responsibilities: Conduct independent quality assurance reviews and claims file audits
Evaluate claims practices for strengths, risks, and opportunities
Identify trends and provide clear recommendations from findings
Partner with operational leaders on constructive practice improvements
Coordinate internal and external audit reviews
Requirements: Disability Management certificate or related bachelor’s degree
Five to eight years of related claims experience
Three years managing complex disability claims as Case Manager
Experience with STD, LTD, Life, and related claims
Robust judgement, detail orientation, and independent prioritization
Bring claims auditing, Disability Management, and compliance expertise to strengthen quality outcomes at Pacific Blue Cross.