Manager of HEDIS Program Management

Reposted 16 Days Ago
Be an Early Applicant
Eagan, MN, USA
In-Office
102K-174K Annually
Senior level
Healthtech • Insurance
The Role
Lead design, implementation, and management of HEDIS performance programs, oversee medical record retrieval and abstraction, partner cross-functionally, set metrics, manage timelines, and supervise program associates to improve healthcare delivery and outcomes.
Summary Generated by Built In
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 the strategic design, development, implementation, evaluation, and ongoing management of programs that improve the delivery of health care services and drive better outcomes for our members. The role will focus specifically on leading the organization’s strategy for HEDIS® performance, including overseeing medical record retrieval, abstraction operations, and advancing enterprise capabilities for ECDS. The incumbent will work closely with leadership and cross‑functional teams to shape and execute strategies that support organizational and divisional priorities. This includes ensuring program designs meet existing and emerging market, provider, and member requirements; resolving complex business challenges; identifying and shaping new opportunities; and supporting effective change management. The role serves as a liaison between multiple internal departments and requires the ability to lead teams across the organization, drive results within tight deadlines, and manage program management associates within the division.
Your Responsibilities
  • Drive the development and documentation of design, requirements and implementation required to support initiatives that align with strategic priorities.
  • Develop relationships and partner with key resources, both internal and external, to collaborate on the design and ensure all market, member, and provider considerations are factored into the design.
  • Drive business decision making process to ensure capabilities, systems and processes meet market expectations and that alternate approaches are vetted and explored.
  • Manage related ongoing program management work to understand what is needed to recommend strategy and solutions, while influencing and steering others to accomplish that strategy across multiple complex programs.
  • Ensure that appropriate metrics are chosen and that the appropriate measurement, data analysis and evaluation occur for each initiative.
  • Develop and continually update program or project plans, timelines and deliverables while coordinating multiple sub-processes to expand and/or improve complex programs.
  • Develop and implement a communication plan in conjunction with leadership and to support initiatives, including status and progress updates.
  • Stay abreast of changes in the rapidly evolving health care marketplace and in regulatory or quality‑measurement programs.
  • May perform other duties as assigned.
Required Skills and Experience
  • 7+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
  • 1 year of management experience, leading a team
  • Demonstrated organizational relationship management skills.
  • Ability to thrive in ambiguity.
  • Strong critical thinking skills and problem solving/conflict resolution skills.
  • Excellent written and verbal communication skills with strong facilitation, negotiation and presentation skills, adapting approach as needed.
  • Attention to detail and time management skills.
  • Self-motivated, ability to work independently, and demonstrated ability to work under tight time frames.
  • Knowledge of the health care industry, payer business models, business segments and products.
  • Proven ability to handle a variety of assignments in a fast paced and complex business environment.
  • Proven ability to define problems, collect and analyze data, establish facts and draw valid conclusions.
  • High school diploma (or equivalency) and legal authorization to work in the U.S.
Preferred Skills and Experience
  • Bachelor’s degree in Business, Health Science or related field or Master’s degree in business, nursing, public health, health sciences, health promotion or related field.
  • Experience in process improvement.
  • Content expertise in the reduction of health risk behavior.
  • Ability to combine traditional health education approaches with policy or other advocacy tactics.

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

$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.

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: [email protected].

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

Skills Required

  • 7+ years of related professional experience
  • 1 year of management experience, leading a team
  • Demonstrated organizational relationship management skills
  • Ability to thrive in ambiguity
  • Strong critical thinking and problem solving/conflict resolution skills
  • Excellent written and verbal communication with facilitation, negotiation and presentation skills
  • Attention to detail and time management skills
  • Self-motivated, ability to work independently, and work under tight time frames
  • Knowledge of the health care industry, payer business models, business segments and products
  • Proven ability to handle a variety of assignments in a fast paced and complex business environment
  • Proven ability to define problems, collect and analyze data, establish facts and draw valid conclusions
  • High school diploma (or equivalency) and legal authorization to work in the U.S.
  • Bachelor's or Master's degree in Business, Health Science, nursing, public health, health sciences, or related field
  • Experience in process improvement
  • Content expertise in the reduction of health risk behavior
  • Ability to combine traditional health education approaches with policy or advocacy tactics

Blue Cross and Blue Shield of Minnesota Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Blue Cross and Blue Shield of Minnesota and has not been reviewed or approved by Blue Cross and Blue Shield of Minnesota.

  • Retirement Support The program combines a 401(k) match with additional company retirement contributions and a cash balance pension. This multi-pronged design strengthens long-term financial security beyond standard offerings.
  • Parental & Family Support Benefits include fully paid parental leave, adoption/surrogacy/foster assistance, and childcare support. These resources provide meaningful support across diverse family needs.
  • Leave & Time Off Breadth PTO that increases with tenure, multiple paid holidays, personal days, and paid volunteer time are paired with flexible scheduling. This breadth supports sustained work-life balance across career stages.

Blue Cross and Blue Shield of Minnesota Insights

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The Company
HQ: Eagan, MN
3,267 Employees

What We Do

Blue Cross and Blue Shield of Minnesota is a taxable, nonprofit organization with a mission to make a healthy difference in people’s lives. Chartered in 1933 as Minnesota’s first health plan, we’ve promoted wider, more economical and timely availability of health services for the people of Minnesota for 80+ years. Blue Cross® and Blue Shield® of Minnesota is a nonprofit independent licensee of the Blue Cross® and Blue Shield® Association.

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