Senior Government Programs & Care Coordination Consultant

BCBSM, Inc.; Eagan (MN); Hybrid; USD 79,000 - 131,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

401k

PTO

VPTO

Job summary

Blue Cross and Blue Shield of Minnesota is hiring a Government Programs Partner Relations Consultant to lead delegated care coordination oversight for MSHO/MSC+ and to collaborate with internal and external stakeholders on performance improvement and regulatory compliance. This hybrid role is anchored in Minnesota, with travel as needed.

The position requires 5+ years in Medicare/Medicaid, a Bachelor’s degree, and strong skills in regulatory guidance, relationship management, and process

Qualifications

• 5+ years of related Medicare / Medicaid 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.
• Ability to travel.
• Knowledge of government healthcare programs, regulations, and compliance requirements.
• Knowledge of health plan operations, products, and business practices.
• Experience improving processes, workflows, or operational performance.
• Ability to communicate complex topics clearly and concisely, actively listen to anticipate stakeholder needs, and align others to drive informed decisions.
• 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 deadlines.

Responsibilities

• Represent the organization on internal and external work groups.
• Maintain regulatory MSHO and MSC+ product expertise and serve as a care coordination SME to partners.
• Collaborate with stakeholders to resolve complex care coordination issues.
• Identify barriers and coordinate cross-functional efforts to support compliance and performance improvement.
• Develop and implement delegate oversight frameworks, monitoring activities, and corrective action processes.
• Lead delegate care coordination guidelines, forms, and training resources.
• Solicit and evaluate stakeholder feedback to improve delegate support and service delivery.
• Perform additional responsibilities consistent with the role as assigned.

Skills

Medicare/Medicaid experience

Ability to travel

Relationship building with external伙伴

Regulatory compliance knowledge

Analytical & cross-functional teamwork

Clear communication of complex topics

Education

Bachelor’s degree

Job description

Blue Cross and Blue Shield of Minnesota is hiring a Government Programs Partner Relations Consultant to lead delegated care coordination oversight for MSHO/MSC+ and to collaborate with internal and external stakeholders on performance improvement and regulatory compliance. This hybrid role is anchored in Minnesota, with travel as needed.

The position requires 5+ years in Medicare/Medicaid, a Bachelor’s degree, and strong skills in regulatory guidance, relationship management, and process