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

The Manager leads a team responsible for the operational oversight, governance, and performance management of Health & Wellness vendor programs within the Clinical Operations organization. This role collaborates closely with cross-functional teams – including Product, Care Management, Data and Analytics and Finance, to ensure seamless transition from vendor implementation to steady-state operations and ongoing program and vendor performance.

The position is accountable for ensuring vendors deliver against service level agreements (SLAs), performance guarantees (PGs) and operations metrics and outcomes, while driving consistent program execution across all lines of business. This includes oversight of vendor performance reporting, issue resolution, and operational integration across internal teams.

This role ensures that program performance, utilization, and financial outcomes are measured, monitored, and communicated to key stakeholders, and that opportunities for operational improvement, efficiencies, and enhanced customer experience are proactively identified and addressed.

Your Responsibilities

Team Leadership & Operating Model Execution

• Lead, coach, and develop a team of Program Managers and Program Specialists.
• Establish and maintain standardized vendor operating model including governance, reporting, and escalation processes.
• Ensure clear role alignment across Product, Vendor Operations, and Procurement

Vendor Governance & Performance Oversight

• Own operational governance of vendor programs post-implementation.
• Ensure vendors meet contractual SLAs, performance guarantees, and service delivery expectations.
• Oversee vendor performance reviews, scorecards, and governance forums.

Operational Performance Reporting

• Ensure consistent, accurate, and actionable vendor reporting.
• Oversee dashboards tracking utilization, outcomes, service levels, and financial performance.
• Translate performance data into operational insights and improvement actions.

Escalation & Issue Resolution

• Provide oversight for escalated vendor issues and operational risks.
• Ensure timely resolution of issues impacting members, clients, and internal stakeholders.
• Establish escalation frameworks and accountability mechanisms.

Cross-Functional Collaboration

• Partner with Product and Care Management teams to ensure effective operational handoffs.
• Collaborate with cross-functional teams as appropriate
• Provide operational insights to inform future product and vendor decisions.

Financial & Contract Oversight

• Monitor vendor financial performance tied to utilization and guarantees.
• Partner with Procurement, Finance, Quality and Compliance to ensure vendor compliance.
• Identify opportunities for cost optimization and performance improvement.

Continuous Improvement

• Drive process improvements and workflow optimization across vendor programs.
• Implement scalable solutions across vendors.
• Ensure consistent member, provider, and client experience.

Required Skills and Experience

• 5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
• Ability to analyze data and transform into program strategies and clinical, financial, and utilization outcome measurements approach as needed.
• Experience in project management, and quality or process improvement.
• Strong interpersonal skills to collaborate and effectively work through a complex organization to influence change.
• Ability to deal with ambiguity and drive for clarity with a sense of urgency.
• Manage and effectively lead a team.
• Excellent organizational and time management skills.
• Well-developed written and oral communication skills.
• High school diploma (or equivalency) and legal authorization to work in the U.S.

Preferred Skills and Experience

• Bachelor’s Degree or equivalent
• Experience managing vendor performance, SLAs, and operational governance
• Experience managing offshore vendors specialized in Business Process & Clinical Process Outsourcing (BPO & CPO)
• Experience managing Third Party Administration (TPA) and Delegated vendors
• Strong analytical and stakeholder management skills
• Experience in health plan clinical programs or wellness programs
• Experience in Vendor Management Office (VMO) or enterprise vendor governance structures
• Experience managing multi-vendor portfolios
• Broad knowledge of the health care industry and managed care.

Compensation and Benefits:

Pay Range: $102,400.00 - $138,300.00 - $174,200.00 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.