Vice President Clinical Operations

Blue Cross and Blue Shield of Minnesota; Eagan (MN); Híbrido; USD 300 000 - 335 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical insurance

Dental insurance

Vision insurance

Life insurance

401k

PTO

VPTO

Resumo da oferta

Blue Cross and Blue Shield of Minnesota is seeking a Vice President of Clinical Operations to provide strategic leadership across case management, utilization management, and behavioral health. You will oversee teams delivering high-quality, cost-effective care, aligning clinical programs with regulatory standards and enterprise priorities.

The role reports to the COO and requires 10+ years in healthcare with 7+ years in leadership, strong collaboration, and a track record of operational

Qualificações

• 10+ years in a health plan or healthcare delivery with 7+ years of people leadership.
• 7+ years of clinical adjacent experience.
• Strong knowledge of healthcare regulations, accreditation standards, and managed care principles.
• Leadership and team management skills including delegation, coaching and mentoring.
• Excellent communication and interpersonal skills.
• Ability to work collaboratively with diverse stakeholders in a matrixed environment.
• Project management skills to plan, execute, and oversee projects on time and budget.
• Familiarity with healthcare IT systems and data analytics tools.
• Strong financial acumen in budgeting and cost control.
• Ability to drive innovation and continuous improvement in clinical operations.

Responsabilidades

• Oversee daily operations of clinical operations and allocate resources to top priorities.
• Collaborate with medical directors and clinical teams to address complex cases and high-risk members.
• Develop and implement strategic plans for clinical operations.
• Drive efficiency and process improvements to enhance member engagement and outcomes.
• Set department goals and performance metrics aligned with enterprise plans.
• Lead change across the organization and provide strategic direction for exceptional member experience.

Conhecimentos

Leadership

Communication

Problem Solving

Collaboration

Project Management

Regulatory knowledge

Financial acumen

Healthcare IT

Change management

Data analytics

Formação académica

RN (Nursing)

Business, Health Care Administration, or Public Health

Ferramentas

EHR systems

Descrição da oferta de emprego

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 Will Have

At Blue Cross and Blue Shield of Minnesota, caring for our members and communities shapes how care is coordinated, how teams work together and how members experience healthcare. Reporting to the COO, the Vice President of Clinical Operations will provide strategic leadership and operational oversight for case management, utilization management, and behavioral health across all lines of business. This leader will lead teams supporting both physical and behavioral health, bringing together clinical expertise, operational excellence, and a commitment to delivering high-quality, cost-effective care. Working closely with the Health services leadership, medical directors, and case management and utilization management product teams, this leader will help shape effective programs, advance evidence-based practices, and ensure alignment with regulatory standards and enterprise priorities. This role offers an opportunity to influence how clinical operations and services evolve to better meet the needs of members and the community's Blue Cross serves. The VP will drive operational performance, establish meaningful measures of success, and champion improvements that strengthen clinical outcomes, efficiency and member satisfaction. To be successful in this role, we are looking for a leader who will foster a culture of collaboration, accountability, and continuous improvement, connecting people, programs, and priorities to create better experiences.

What You’ll Do

• Oversee daily operations of clinical operations ensuring the proper allocation of resources to the highest priority deliverables
• Collaborate with medical directors and other clinical teams to address complex cases and high-risk members; collaborate with cross functional departments to drive outcomes (claims, appeals, service, payment integrity, etc.
• Develop and implement strategic plans for clinical operations.
• Enhance operational efficiency and implement process improvements to enhance and optimize member engagement, quality of services and outcomes to support product development, operational productivity and execution.
• Establishes and drives department goals and performance metrics that support the division and enterprise strategic plans.

How You’ll Do It

• Support enterprise-wide initiatives and effectively lead change. Provide strategic direction on how to support exceptional experience for internal and external customers and stakeholders.
• Provide leadership and direction to the organizational leaders and staff.
• Prepare and present reports on departmental performance to senior leadership and any auditing bodies.
• Advocate for the needs and interests of members in clinical operations initiatives.
• In partnership with the broader health services team, ensure adherence to clinical guidelines and evidence-based practices.
• Ensure alignment of departmental goals with organizational objectives and regulatory standards.
• Ensure compliance with all relevant regulations, accreditation standards, and organizational policies.
• Ensure associates and vendors have the appropriate structure, tools, resources, required to perform their job at the highest levels.
• Performs additional responsibilities consistent with the scope and level of the role, as assigned.

Required Skills & Experience

• 10+ years of related professional experience in a health plan or healthcare delivery system with 7+ years of people leadership. All relevant experience including work, education, transferable skills, and military experience will be considered.
• 7+ years of clinical adjacent experience
• Strong knowledge of healthcare regulations, accreditation standards, and managed care principles.
• Leadership: Excellent leadership and team management skills, including delegation, coaching, and mentoring skills to manage and empower staff to meet all required objectives.
• Problem Solving: Strong analytical and problem-solving abilities, including the ability to balance competing priorities, develop and implement strategic initiatives, and resolve operational issues and conflicts.
• Communication: Effective communication and interpersonal skills.
• Collaboration: Ability to work collaboratively with diverse stakeholders including product development teams, and experience working across a highly matrixed environment.
• Project Management: Skills in planning, change management, executing, and overseeing projects to ensure they are completed on time and within budget.
• Technology Proficiency: Familiarity with healthcare IT systems, electronic health records (EHR), and data analytics tools.
• Financial Acumen: Strong understanding of financial management, budgeting, and cost control in healthcare operations.
• Innovation and Creativity: Ability to think creatively and implement innovative solutions to improve clinical operations processes with a focus on continuous improvement.
• Risk Management: Skills in identifying, assessing, and mitigating risks in healthcare operations.

Preferred Skills & Experience

• RN experience
• Previous experience in managing vendor relationships
• Education or equivalent experience in Business, Health Care Administration, or Public Health.

Role Designation

Hybrid

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

Pay Range: $300,000.00 - $317,500.00 - $335,000.00 Annual

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.