Appeals & Grievances Manager — Change & Compliance

Blue Cross and Blue Shield of Minnesota; Eagan (MN); Hybrid; USD 102,000 - 174,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

Life insurance

401k

PTO

Volunteer PTO

Job summary

Blue Cross and Blue Shield of Minnesota is seeking a seasoned leader to manage corporate appeals and drive process improvements. The role focuses on reducing appeals backlog, guiding complex issue resolution, and ensuring regulatory compliance across departments and with external partners.

You will oversee escalation paths, collaborate with compliance, legal, and providers, and steer cross-functional teams to optimize workflows while maintaining high-quality service for members and customers.

Qualifications

• Bachelor’s degree or equivalent experience.
• 5+ years in customer service/operations with team lead or project lead experience.

Responsibilities

• Identify and evaluate appeal trends and implement strategies.
• Own escalated corporate appeal process for the Corporate Appeals Committee.
• Lead internal workgroups/committees for core projects affecting workflow and vendor relationships.
• Evaluate and drive implementation of new technical solutions to improve efficiency.
• Act as a change agent, leading organizational initiatives and fostering continuous improvement.

Skills

Customer service experience

Team leadership

Operations experience

Change management

Education

Bachelor’s degree

Masters degree (preferred)

Job description

Blue Cross and Blue Shield of Minnesota is seeking a seasoned leader to manage corporate appeals and drive process improvements. The role focuses on reducing appeals backlog, guiding complex issue resolution, and ensuring regulatory compliance across departments and with external partners.

You will oversee escalation paths, collaborate with compliance, legal, and providers, and steer cross-functional teams to optimize workflows while maintaining high-quality service for members and customers.