Director of Clinical Ops – Utilization Management Leader

BCBSM, Inc.

Eagan (MN)

Ibrido

USD 136.000 - 230.000

Tempo pieno

9 giorni fa

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Descrizione del lavoro

Blue Cross and Blue Shield of Minnesota in Eagan, MN invites a Director, Clinical Operations to lead Utilization Management. You will provide strategic clinical leadership, drive quality, affordability, and positive member outcomes, partnering with clinical, medical, product, data, and technology teams.

The role emphasizes change leadership, building leaders, and translating enterprise priorities into actionable plans.

Competenze

7+ years of progressive health services experience with 3+ years of management experience.
Bachelor's degree; in lieu of a degree, an additional two years of relevant experience may be accepted.
Master's degree in a related field is preferred.
Healthcare or managed care background with knowledge of medical terminology, health insurance, and social determinants of health.

Mansioni

Direct clinical and operational leadership of Utilization Management, focusing on quality, affordability, compliance, and positive member outcomes.
Advance UM practices to support sound clinical decisions, operational performance, and continuous improvement.
Develop leaders who translate strategy into clear priorities and guide teams through change.
Oversee vendor and delegated clinical operations, ensuring alignment with UM standards and performance objectives.
Collaborate with clinical, medical, Product, data, and technology teams to solve complex problems and align priorities.
Use performance data and benchmarks to identify trends and guide decisions.