Program Manager Senior - Quality Program & Governance

BCBSM, Inc.; United States; Hybrid; USD 91,000 - 150,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

401k

Paid Time Off

Volunteer Paid Time Off

Job summary

Blue Cross and Blue Shield of Minnesota is seeking a senior program leadership professional to oversee enterprise-wide quality program management, regulatory compliance, and accreditation readiness across all lines of business. The role partners with leaders to strengthen governance and drive continuous improvement.

Hybrid role with two onsite days per week; you will manage multiple programs, analyze metrics, update plans, and ensure alignment with NCQA, CMS, DHS, and state requirements, while

Qualifications

• 5+ years of related project/program management professional experience.
• Bachelor’s degree; in lieu of a degree, an additional two years of relevant experience beyond the qualifications listed above may be accepted.

Responsibilities

• Drive the development and documentation of design, requirements and implementation of multiple strategic programs.
• Maintain strategic relationships with key internal and external resources to support design and ensure market, member, and provider considerations are factored into the design.
• Support business decision making to ensure capabilities and processes meet market expectations and that alternate approaches are explored.
• Manage and monitor metrics, update plans and timelines, and coordinate cross-functional sub-processes to expand and improve programs.

Skills

Project management

Communication

Stakeholder management

Regulatory knowledge

Lean Six Sigma

Education

Bachelor's degree

Tools

PM tools

Microsoft Analytics tools

Job description

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'll Have

This position provides leadership and oversight for enterprise-wide quality program management activities that support quality improvement, accreditation readiness, regulatory compliance, and strategic priorities across all lines of business. The role partners with leaders and stakeholders across the organization to strengthen quality governance, oversee quality committees and work plans, ensure compliance with NCQA, CMS, DHS, MDH, and other regulatory and accreditation requirements, and drive continuous improvement through effective planning, monitoring, documentation, and cross-functional collaboration.

What You'll Do

Drive the development and documentation of design, requirements and implementation of multiple strategic programs. Maintain strategic relationships and partner with key resources, both internal and external, to support the design and ensure market, member, and provider considerations are factored into the design. Support the business decision making process to ensure capabilities, systems and processes meet market expectations and that alternate approaches are vetted and explored. Support the ongoing program management work of multiple programs to ensure the strategy is in alignment to solutions put forth through skills of influence.

How You'll Do It

Manage and monitor multiple appropriate metrics, perform data analysis and evaluation for each initiative. Continually update program or project plans, timelines and deliverables while coordinating multiple sub-processes to expand and/or improve programs. Manage multiple communication plans in conjunction with leadership and to support initiatives, including status and progress updates. Stay abreast of changes in the rapidly evolving health care marketplace. Performs additional responsibilities consistent with the scope and level of the role, as assigned.

Required Skills & Experience

5+ years of related project/program management professional experience. Bachelor’s degree; in lieu of a degree, an additional two years of relevant experience beyond the qualifications listed above may be accepted.

Preferred Skills & Experience

Exceptional communication and stakeholder management skills, with the ability to translate complex regulatory, quality, and operational concepts into clear, actionable information for various audiences and drive alignment across the organization. Ability to analyze complex information, evaluate options, and work cross-functionally to drive resolution and prevent recurrence. Ability to effectively organize work, balance competing priorities, and manage time across complex assignments and competing deadlines. Healthcare or managed care experience. Experience leading complex cross-functional initiatives and projects which may involve multiple team members, task assignment, working with internal or external clients, managing teams and customer relationships, and managing project deliverables. Experience in data-driven decision-making. Experience with process improvement methodologies, such as Lean, Six Sigma, PDSA or other continuous improvement frameworks. Familiarity with PM tools & Microsoft analytics tools. Knowledge of healthcare quality measurement and performance programs, such as HEDIS, Stars, CAHPS, accreditation standards, quality improvement programs, or population health initiatives. Experience supporting governance structures, committees, and regulatory reporting, including preparing meeting materials, documenting decisions, tracking action items, and ensuring compliance with organizational and regulatory requirements.

Role Designation

Hybrid Role designation definition: Teleworking is working full time remote. Hybrid is a minimum of 2 days onsite. Onsite is full-time onsite.

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

$90,800.00 - $120,300.00 - $149,800.00 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: [e-mail].

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

Physical requirements. Chartered in 1933 as Minnesota’s first health plan, this company is one of the most recognized and trusted healthcare brands in the world. It has more members, the largest network of doctors, and more products and services than any other health plan in Minnesota. Headquartered in Eagan, Minnesota.