A Career of Your Calling

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 is responsible for supervising the people, daily activities, and deliverables of the Medical Record retrieval team within the Value Performance Team. The supervisor will provide workflow direction and subject matter expertise to ensure the record retrieval projects are managed closely, ensuring timely and successful completion. This position supports Healthcare Effectiveness Data and Information Set (HEDIS) and quality projects.  Primary accountabilities are related to the coordination and implementation of activities supporting accurate and timely record retrieval and storage efforts, adherence to regulatory and project timelines, and protection of PHI. This position will ensure appropriate quality assurance across all records retrieved. Collaboration with multiple stakeholders at many levels across the company, as well as with external entities, providing coordination and support as required are key elements of this position.

Your Responsibilities

• Managing release of information requests-medical record retrieval and record check-in work streams to ensure timely submission of records for internal and external coding teams. This includes effective tracking of requests, ongoing assessment of timelines, escalations and driving efforts to ensure department goals for successful and accurate medical record retrieval and coding are met.
• Coordinate, track, and update process flows and training materials for medical record retrieval initiatives, ensuring process timeliness, information accuracy, and compliance with processes to protect PHI are followed.
• Assist internal and external stakeholders to troubleshoot and assist in the resolution of any logistical or technical issues regarding records requests and management. Assume a key role in the development of new processes and tracking system improvements to support best practices in medical record storage and document management procedures. Identify process issues and contribute to the design of solutions; proactively implement process improvements.
• Working with the manager, implements communication and reporting processes for record retrieval projects including provider and care system information updates, dashboard updates, and distribution of communication materials to internal and external stakeholders.
• Assist with maintaining Medical record retrieval software tool and PHI repository for the quality department. 
• Supervises the medical record retrieval team including interviewing and hiring employees and contractors following required EEO and Affirmative action guidelines and ensuring employees receive proper onboarding and training.
• Conducts performance evaluations, and is responsible for managing employees, including skill and career development, policy administration, performance management, employee relations and cost control.
• Supervises contract staff and works with manager to provide ongoing feedback to staff augmentation vendor as well as internal vendor management/procurement team on vendor performance.
• Perform other duties as assigned.

Required Skills and Experience

• 3+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
• Certifications such as (not limited to) CRC, CPMA, RHIT, RHIA, CPC, CCS  Ability to track and manage work to ensure work is completed as required and deadlines are met.
• Successful staff management experience, with excellent performance management and coaching skills.
• Excellent organizational and project management skills to efficiently manage concurrent projects within tight timelines; ability to prioritize responsibilities with attention to detail.
• Excellent communication skills and demonstrated ability to develop accurate and appropriate communications Must be self-motivated, able to take initiative, and work independently with minimal oversight to meet timelines; strong follow through skills and a solutions-oriented attitude.
• Ability to work well under pressure; exhibit professional demeanor.
• Proven time management skills.
• Team player with ability to build and maintain relationships with cross-functional business partners, both internal and external
• Strong proficiency in navigating Electronic Medical Record (EMR) systems.
• Strong proficiency with MS Office Suite.
• Willingness and ability to travel as needed to support record retrieval efforts.
• Expert level proficiency in navigating EMR systems.
• Expert level proficiency in using MS Office.
• High school diploma (or equivalency) and legal authorization to work in the U.S.

Preferred Skills and Experience

• Bachelor's degree.
• Current knowledge of industry audit standards and in-depth understanding of statistical sampling methods and risk adjustment methodology HEDIS or Stars experience.
• Proficient knowledge of CMS-HCC , HHS, HCC, and CDPS-Rx model and guidelines.
• Demonstrated ability to apply critical thinking skills to coding policy interpretation and implementation.
• Experience with risk adjustment coding and methodology. Strong experience with ICD-9 and/or ICD-10 coding, medical record review and audit, quality assurance of clinical practices and experience with Medical Records.
• Knowledge of healthcare quality regulatory requirements and related to government agencies. Excellent business communication and relationship skills, including experience leading collaborative teams, building long term collaborative relationships, and managing external relationships with vendors and regulatory agencies.
• Health Plan 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.