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'll Have The Restricted Recipient Support Coordinator (RRSC) role is designed to support the Restricted Recipient Program Specialist and the Restricted Recipient program (RRP). In this position, you will support the program specialists by managing the incoming referrals for potential RRP members, triaging incoming calls from members and providers regarding the RRP program, completing administrative requests, and in completing all data entry for restriction information in multiple systems. You will also have direct contact with members who are enrolled in the RRP program, as well as clinical providers and pharmacies who provide care to these members. You may also outreach to providers or hospitals on behalf of the Restricted Recipient Program Manager or Medical Director.
While this role is fully remote, we welcome all qualified applicants; however, preference will be given to candidates currently located in Minnesota. What You'll Do
- Prioritize RRP program referrals through system work queue management, mailbox management, daily activity reports, incoming telephonic referrals and any other method deemed necessary for member program enrollment.
- Review referrals for completeness of information and attempt to resolve when appropriate (eligibility information, accurate phone number, etc.).
- Ensure Restricted Recipient Program Specialists receive referrals or other information in a timely manner and according to established practices, workflow processes and departmental needs.
- Accurately apply specific guidelines, policies and procedures as authorized by medical management.
- Completes all system documentation per process and regulatory standards within Medical Management, DHS, and external vendor systems.
- This role will be responsible for all restriction information data entry in accordance with DHS administrative rules and guidelines. Triage all incoming calls from members and providers regarding RRP.
- RRSC's must be able to apply program rules to incoming exception requests and complete administrative exceptions per established Medical Management and DHS guidelines.
- Complete outbound calls to providers and facilities per established guidelines or as directed by Restricted Recipient Program Specialists or the Medical Director.
- Recognize opportunities for improvement and initiate workflow changes in collaboration with leadership and staff. Demonstrate the ability to modify approach based on customer demands.
- Actively participate as a member of a team and provide input to assure that quality standards and continuous quality improvement activities are met. Accept accountability for more complex assignments and special projects that require moderate to complex research, analysis and documentation skills.
- May assist manager with daily workload balancing and other work inventory assignment tasks.
- Performs additional responsibilities consistent with the scope and level of the role, as assigned.
- 4+ years of experience in related role or 2+ years internal experience.
- High school diploma (or equivalent)
- Ability to communicate detailed information to diverse audiences, actively listen to understand varied perspectives, and facilitate alignment on operational priorities.
- Ability to analyze complex operational issues, evaluate tradeoffs, and collaborate with stakeholders to reach effective, sustainable solutions.
- Ability to organize work across multiple assignments, balance shifting priorities, and manage time to meet commitments while supporting team coordination.
- Healthcare experience and/or knowledge of the managed care and health care/insurance industry.
- Experience with healthcare regulations including Mental Health Parity (MHPAEAA) Federal Regulatory requirements and applicable state laws.
- Medicaid and commercial insurance experience.
- Understanding of population health management trends, clinical program design, and healthcare market dynamics.
- Experience developing and implementing strategy and strategic initiatives.
- Process improvement and ability to implement tools or systems that improve team efficiency and accuracy.
- Understanding of medical claims and coding.
Role designation definition:
- Teleworking is working full time remote.
- Hybrid is a minimum of 2 days onsite.
- Onsite is full-time onsite.
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 StatementAt 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.
Physical requirements.
Skills Required
- 4+ years of experience in a related role, or 2+ years of internal experience
- High school diploma or equivalent
- Ability to communicate detailed information to diverse audiences, actively listen, and facilitate alignment on operational priorities
- Ability to analyze complex operational issues, evaluate tradeoffs, and collaborate with stakeholders on sustainable solutions
- Ability to organize multiple assignments, balance shifting priorities, manage time, and support team coordination
- Healthcare experience or knowledge of managed care and the healthcare insurance industry
- Experience with healthcare regulations, including Mental Health Parity and applicable state laws
- Medicaid and commercial insurance experience
- Understanding of population health management trends, clinical program design, and healthcare market dynamics
- Experience developing and implementing strategy and strategic initiatives
- Process improvement experience and ability to implement tools or systems improving team efficiency and accuracy
- Understanding of medical claims and coding
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.
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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.
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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.
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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
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.
