Blue Cross and Blue Shield of Minnesota hiring Manager Clinical Enablement in Eagan, Minnesota, United States | LinkedIn (2024)

About Blue CrossBlue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We’re committed to reinventing health care to improve health for our members and the community. We hope you'll join us.

How Is This Role Important To Our WorkThis role is 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.

They are responsible for ensuring that platforms, systems, applications and processes are reliable, effective, and configured to be compliant with industry standards and regulations. They are also 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.

A Day In The Life

• 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.
• 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.

Nice To Have

• Bachelor’s degree

Required Skills & Experiences

• 5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
• 3+ years of experience in platforms, systems, and applications operations, preferably in a managed care setting.
• Strong knowledge of health plan operations, benefits, eligibility, and regulations.
• Excellent communication, leadership, and problem-solving skills.
• Demonstrates technical competence and proficiency in various software tools and platforms.
• Demonstrates the ability to bridge business outcomes and technical solutions by working with stakeholders from both backgrounds.
• Experience working in an Agile and/or Product led structure.

Make A DifferenceBlue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, gender expression, or any other legally protected characteristic.

Reasonable Accommodation for Job Seekers with a Disability: If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talent.acquisition@bluecrossmn.com.

All roles require a high school diploma (or equivalency) and legal authorization to work in the U.S.

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