Job Description

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

In this role, you will be responsible for leading a team that serves as a conduit between the clinical operations teams, product teams and technology to effectively design, develop, implement, and maintain platforms, systems, applications and processes that enable efficient and effective clinical operations. You will be responsible for ensuring that platforms, systems, applications and processes are reliable, effective, and configured to be compliant with industry standards and regulations. In this role, you will be responsible for liaising with operations leaders and applying data-driven models to continually iterate staffing models, processes, technology, and automation to improve efficiency and clinical operations outcomes. The work of the team is highly matrixed and requires close collaboration with multiple departments including case management operations, utilization management operations, IT, data & analytics, enterprise value delivery and business partnerships & negotiations to understand needs and requirements of end-users and stakeholders.

What You’ll Do

• Monitors system, platform and application performance over time. Escalates & helps remediate priority issues quickly. Tracks and problem solves pervasive issues to prevent long-term impacts to business operations.
• Manages and evaluates configuration work provides feedback and coaching.
• Oversees the development and implementation of policies and procedures, performance metrics, and quality assurance standards for Medical Management platforms, systems, and applications.
• Oversees the configuration, implementation, and maintenance of the medical management software systems and applications.
• Assists the team in troubleshooting and resolving any issues or defects related to the medical management platforms, systems, applications.
• Monitors and analyzes data and reports on the outcomes and effectiveness of medical management platforms, systems, and applications. Works with matrixed stakeholders including operations leaders, product managers and business partnerships & negotiations to ensure platforms, systems, and applications are robust and performing effectively to enable strategic operations goals and product roadmaps.

How You’ll Do It

• Continually find ways to improve processes and support clinical teams, while maintaining high quality standards including oversight of workforce management tools and deployment of automation functions.
• Effectively coordinate and focus the work of skilled employees toward strategic division initiatives, prioritizing work and driving incremental value.
• Build partnerships with matrixed internal stakeholders to facilitate collaboration and speed to delivery.
• Performs additional responsibilities consistent with the scope and level of the role, as assigned.

Required Skills & Experience

• 5+ years of progressive information technology experience, with 1+ staff, team lead or project lead experience.
• Bachelor’s degree; in lieu of a degree, an additional two years of relevant experience beyond the qualifications listed above may be accepted.

Preferred Skills & Experience

• Masters degree in related field
• Utilization Management experience.
• Ability to communicate expectations and priorities clearly to team members, actively listen to resolve issues and remove barriers, and drive alignment across teams and stakeholders.
• Capability to analyze department challenges, guide team decision-making, and collaborate across teams to drive resolution and next steps.
• Able to effectively organize team work, balance priorities across projects, and manage time and resources to ensure timely delivery and coordination.
• Proficiency with business technology platforms, systems, software, and tools.
• Understanding of business operations, processes, or domain context.
• Ability to analyze information and support business decisions, solutions, or process outcomes.

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.

Compensation and Benefits:

Pay Range: $117,800.00 - $159,000.00 - $200,200.00 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.

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.

Physical Requirements