About Blue Cross and Blue Shield of Minnesota

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.

The Impact You Will Have

This position will oversee county and non-traditional provider relations that support government programs wide range of Medicare and Medicaid products. The position will lead the development of and provision of semi-annual delegate training, conducting annual care plan audits and ensuring post-audit follow up, serving as a regulatory and Blue Plus subject matter expert/resource and providing delegate oversight.

Your Responsibilities

• Develop and maintain cross-functional business relationships with internal and external partners in order to effectively manage product lines, drive product-related process improvement and provide leadership of collaborative teams that cross departments and BCBSM business units, such as Network Management and Integrated Health Management, and community provider partners.
• Staff internal and external work groups. Maintain technical and regulatory Government Programs product expertise and serve as product resource and expert to internal and external partners.
• Provide day to day product management oversight for operations and budget. Lead the development of training curriculum and provision of semi-annual delegate training both face to face or through webinar technology.
• Lead the planning and execution of annual care plan audits, including assisting in the development of the audit protocol and process design and required post audit follow up. Implement and maintain a comprehensive delegate oversight program to ensure that contracted entities adhere to contract and compliance requirements and, in consultation with Manager, impose corrective and/or disciplinary action plans when required.
• Foster effective delegate relationships through facilitation, coaching, mentoring, and teaching. Lead the development of delegate guidelines, forms, resources, and process improvement initiatives.
• Coordinate product related promotional activities such as conference booths, ad hoc trainings, and child and teen check-up/lead screening outreach activities.

Required Skills and Experience

• 5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
• Exceptional and demonstrated ability to build strong working relationships with vendor partners and internal and external business partners.
• Demonstrated ability to work independently and handle a variety of responsibilities.
• Exceptional and demonstrated organizational and time management skills with ability to shift priorities as business demands require.
• Excellent and demonstrated facilitation and presentation skills.
• Exceptional and demonstrated conceptual and analytical skills.
• Exceptional and demonstrated ability to think and plan strategically; strong attention to detail.
• Must be self-motivated with strong initiative to learn.
• Exceptional and demonstrated effective verbal and written communication skills.
• Demonstrated process and quality improvement experience.
• Ability to travel.
• High school diploma (or equivalency) and legal authorization to work in the U.S.

Preferred Skills and Experience

• Bachelor's degree.
• Registered Nurse, Public Health Nurse, or licensed Social Worker with current MN license.
• 3 years of working knowledge of current managed health care field and key competition.
• Mentoring, coaching experience.
• Health related auditing experience.

Compensation and Benefits:

Pay Range: $77,200.00 - $102,300.00 - $127,400.00 Annual

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

• Medical, dental, and vision insurance
• Life insurance
• 401k
• Paid Time Off (PTO)
• Volunteer Paid Time Off (VPTO)
• And more

To discover more about what we have to offer, please review our benefits page.

Role Designation

Hybrid

Anchored in Connection

Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week – most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote.

Equal Employment Opportunity Statement

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic.

Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talent.acquisition@bluecrossmn.com.

Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.