Quality Standards Analyst

Quality Standards Analyst

Join our team and 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.

To better serve our customers, we are fostering a culture that emphasizes employee growth, collaborative innovation, and inspired leadership. We are dedicated to creating an environment where employees can excel and where top talent is attracted, retained, and thrives. As a testament to these efforts, Premera has been recognized on the 2025 America's Dream Employers list. Newsweek honored Premera as one of America's Greatest Workplaces, America's Greatest Workplaces for Inclusion, and America's Greatest Workplaces For Mental Well-Being, Forbes ranked Premera among America's Best Midsize Employers for the fourth time.

The Quality Standards Analyst acts as an internal consultant for compliance and regulatory issues for health plan quality accreditation and governmental program quality compliance. In this highly visible role, this Analyst is working across Premera and is responsible for facilitating the development, planning and implementation of policies, procedures and systems necessary to meet accreditation, health plan function delegation, and other regulatory requirements. The Quality Standards Analyst performs audit and reporting to ensure policies, procedures and systems are sufficient, and can adapt to changing requirements.

What you'll do :

• Provides expert accreditation and regulatory compliance interpretation to Quality Program leadership, and across Premera to ensure optimal accreditation standards and regulatory compliance is maintained.
• Facilitates the interpretation and integration of accreditation and regulatory requirements into the standards workflows of the organization through development and execution of cross-functional projects.
• Responds to audits and other inquiries from private and public regulators. Assists Level II Analysts with contacting regulatory agencies.
• Develop audit and survey educational tools and materials for managers and associates.
• Develops tools for collecting, analyzing and synthesizing data applicable to accreditation and compliance policies, procedures and systems.
• Provides oversight of policies, procedures and systems to ensure that Premera is meeting compliance and regulatory requirements through completion of regularly scheduled audits (e.g. appeal audits, denial audits).
• Identifies trends and patterns that may be targeted opportunities for improvement.
• Maintains organized and effective documentation of all program activities.
• Presents findings and recommendations of accreditation and compliance efforts to appropriate management within Premera.
• Identifies and reports delegation compliance status and risks to Level II Analysts on Business Associates (i.e. Vendors) delegated programs, (including but not limited to) Utilization Management, Case Management or Disease Management through methods such as pre-delegation assessment, annual review, and corrective action oversight.
• Educate and raise the awareness of associates regarding the significance of regulations, to enhance ongoing understanding of and compliance with regulatory requirements.
• Performs other duties as assigned.

What you'll bring :

Work is performed within a normal office environment with ambient temperatures.

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.

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 :

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.

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.

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 Plus Salary Range : $78,000.00 - $115,100.00. 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.