About Blue Cross

Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We’re committed to reinventing health care to improve health for our members and the community. We hope you'll join us.

How Is This Role Important to Our Work?

This position is responsible for managing and planning the activities associated with the Customer Service Contact Center, including performance management, auditing, managing to a budget/P & L, and handling escalated issues. Additional responsibilities include interacting and coordinating with other functions at Blue Cross within and outside of Operations; Project management and implementation responsibilities; participating in and representing the Operations division in company initiatives The Manager is responsible for implementing department specific strategies to enhance customer/member experience and improve operational effectiveness. This position will develop and lead cross-functional Benefit Development and Implementation work teams which will include collaboration with, but not limited to, Sales, Product Management, Underwriting.

A Day in the Life:

• Manages a department and team(s) within Operations and is responsible for timely and accurate processing of department specific metrics and goals according to internal, Association, regulatory and customer requirements.
• Metrics and goals include MTM, IPP Scorecard, FEP Scorecard, Performance Guarantees, Prompt pay, budget, and other goals.
• Assesses department issues and recommends solutions; collaborates with other areas to implement process improvements. Plans, develops and implements process improvement, department initiatives and objectives, cost containment programs and effective work flows and procedures.
• Manages the department including interviewing and hiring employees following required EEO and Affirmative Action guidelines, company policy and ensuring employees receive the proper training. Conducts performance evaluation, and is responsible for managing employees, including skill and career development, policy administration, coaching on performance management and behavior, employee relations and cost control.
• Establishes, monitors and communicates overall departmental performance information (metrics, inventory, complaints, etc.) and ensures adherence to performance standards. Cross train staff and develop department policies and procedures/training materials.
• Manages the interpretation, implementation and communication of benefit plans; assesses the technical aspects of system interfaces; initiates and coordinates changes. Resolves complex and sensitive internal and external customer issues that require management intervention, and/or effective coordination with other departments, Blue plans or external partners.
• Effectively navigate Operations department specific systems as appropriate.
• Analyze and summarize results of projects, as well as develop weekly reporting of team activities and workloads. Maintain compliance with contractual guidelines for hearings, claims, disputes, recoveries, etc; review performance data to monitor achievement and overall effectiveness and make business decisions that are financially responsible and justifiable.
• Create and foster a workplace culture that is consistent with the overall organizations and that emphasizes the principles and values of the organization.
• Maintains business relationships with clients and customers and establishes strong working relationships throughout the organization.
• Leads or participates in internal work-groups to represent the consumer perspective and facilitate change to business workflows and technology.
• Assesses the department and audit infrastructure by providing analysis, recommendations and business requirements to ensure efficient implementation of functional and systematic changes. Coordinates the installation of changes with IS and other business partners (internal and external).
• Collaborate with I.S., Sales, Product Management and Operation teams to determine business requirements and solutions.
• Maintain strong working relationships with other BCBSMN departments including Contracts, Underwriting, I.S., Claims, Customer Service, and Product Management.

Required Skills and Experiences:

• 5 years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
• 1 year staff, team lead or project lead experience.
• Demonstrated ability to lead and manage projects.
• Demonstrated ability to coach and develop others.
• Strong analytical, problem solving, decision making and critical thinking skills and ability to use sound judgment in resolving complex issues.
• Advanced interpersonal skills, communication skills (verbal, written and listening), facilitation and presentation skills.
• Experience with technology based solutions.
• Intermediate experience with the Microsoft Office Suite products.
• Must have managed at least 5 direct reports from a previous or current role.

Nice to Have:

• Bachelor's degree.
• Experience in a Customer Service Contact Center.
• Previous healthcare insurance experience.

Make A Difference

Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, gender expression, or any other legally protected characteristic.

Reasonable Accommodation for Job Seekers with a Disability: If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talent.acquisition@bluecrossmn.com.

All roles require a high school diploma (or equivalency) and legal authorization to work in the U.S.

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