Blue Cross and Blue Shield of Minnesota · 4 hours ago
Director of Value Performance Submissions and Analytics
Eagan, MN
Full-time
Hybrid
Mid, Senior Level
$132K/yr - $225K/yr
7+ years expBlue Cross and Blue Shield of Minnesota is committed to transforming healthcare and achieving healthier lives for everyone. The Director of Value Performance Submissions and Analytics leads a team focused on risk adjustment and quality programs, overseeing data collection and government submissions while ensuring alignment with corporate goals.
Insurance
Responsibilities
Develop, lead, and provide strategic direction for a high performing team responsible for maintaining, executing, and evaluating initiative impacts using the risk adjustment and quality analytics models across ACA Commercial, Medicare, and Medicaid
Develop, lead, and provide strategic direction for a high performing team responsible for the execution and day-to-day management of data submissions for ACA Commercial, Medicare, and Medicaid risk adjustment and quality programs
Design and execute complex analytic strategies - including benchmarking, prevalence tracking, cohort stratification, predictive modeling, and suspecting logic leading to accurate risk adjustment scores and supporting quality measure gap closure
Direct data preparation for analytic efforts by establishing data quality and accuracy standards; approving system improvements to enhance overall quality of data; championing the resolution of critical issues as appropriate; and reviewing complex or high-profile data sets
Oversee the development, implementation, and automation of business and reporting strategies by partnering with key stakeholders to ensure their design, planning, and implementation needs are being met while ensuring alignment with strategic business objectives; reviewing and approving results and roadmaps as appropriate; ensuring compliance with standards and guidelines for data reports, visualizations, and/or interactive Business Intelligence (BI) reports; and sharing insights with stakeholders on key findings
Direct research, analyses, and interpretation of risk adjustment and quality data and provide technical assistance to other departments including Underwriting, Government Programs, Finance, Network Management, Health Management, Sales and Marketing, Legal, and Senior Staff
Responsible for synthesizing complex findings into clear, compelling narratives that support strategic decision-making and stakeholder alignment
Review and maintain processes to assess and prevent data loss that may impact risk adjustment accuracy or quality programs
Engage, participate, and present in risk adjustment and quality strategic planning activities by partnering with internal stakeholders to develop strategies, goals, objectives and initiatives that align to corporate and divisional priorities
Provides leadership and oversight with responsibility for key employment decisions including selection, onboarding, performance management, coaching skill and career development, policy administration, employee relations, and cost control
Qualification
Required
Accepting this director level position at BCBSMN requires signing an Employee Confidentiality, Intellectual Property Assignment and Restrictive Covenants Agreement as a condition of employment
7+ years of related professional experience, with 3+ years of management experience. All relevant experience including work, education, transferable skills, and military experience will be considered
Excellent knowledge of Medicare Advantage and/or the ACA marketplace and understanding of CMS initiatives and reasoning
Advanced knowledge of Microsoft SQL Server and its BI tools (SSIS, SSRS), with strong data capabilities to interpret complex data and develop strategic data-driven recommendations
Strong knowledge of data visualization software
Exceptional creative thinking, problem-solving, and critical thinking skills
Excellent communication, collaboration, consultation, presentation, and interpersonal skills
Clearly and effectively communicates technical concepts, issues, and solutions to non-technical audiences
Ability to lead others and build relationships
Demonstrated delegation and management skills
High school diploma (or equivalency) and legal authorization to work in the U.S
Preferred
Master's degree in Finance, Mathematics, Computer Science, Health Science or Data Science
Experience leading Risk Adjustment submission teams in a Health insurance companies, Healthcare providers, Healthcare technology add regulators (CMS, department of health, etc) and consulting companies
Experience leading HEDIS data collection and submissions
Knowledge of statistical software (R or SAS)
Benefits
Medical, dental, and vision insurance
Life insurance
401k
Paid Time Off (PTO)
Volunteer Paid Time Off (VPTO)
And more
Company
Blue Cross and Blue Shield of Minnesota
About Blue Cross Blue Cross and Blue Shield of Minnesota is a taxable, nonprofit organization with a mission to make a healthy difference in people’s lives.
1001-5000 employees
H1B Sponsorship
Blue Cross and Blue Shield of Minnesota has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (2)
2024 (4)
2023 (7)
2022 (2)
2021 (3)
2020 (5)
Funding
Current Stage
Late StageLeadership Team
Carrie S. Lawrence
Executive Administrator to the President & CEO and Chief of Staff
Patsy Riley
Chief Goverment Officer and Senior Vice President and CEO, ClearStone Solutions
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