What are the responsibilities and job description for the Director Core Services - Medicaid position at bcbsmn?
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 As the Medicaid Core Services Leader, you serve as the primary liaison between Blue Cross and Blue Shield of Minnesota and the Minnesota Department of Human Services (DHS) for public services programs and other key stakeholders. This role is accountable for Care Coordination, Transportation, and future services contract performance and regulatory compliance across Medicaid programs. You will shape and lead initiatives that enhance P&L performance, build strong partner relationships, improve operational excellence, and continuously improve role and team impact to deliver an exceptional member experience, ensuring continued market share and profitability. What You'll Do Acts as the primary point of contact and liaison with DHS and other state agencies for execution of Medicaid product contracts. Directs all activities related to Government Programs products (PMAP, MNCare, MSC , MSHO). Builds and maintains strategic relationships across the enterprise and with state government as customer and regulator. Oversees contract management with DHS and CMS, with accountability for regulatory compliance. Manages benefits contract negotiations, requirements gathering, configuration, and issue analysis. Manages care coordination delegate programs with accountability for audit outcomes, financial performance, and value-based contract adherence. Leads participation in Public Program contract negotiations and new program development. How You'll Do It Allocating resources and setting team priorities. Accountable for the full associate lifecycle, including workforce decisions, performance and talent management, employee relations, policy compliance, and cost control. Performs additional responsibilities consistent with the scope and level of the role, as assigned. Required Skills & Experience 7 years of progressive Medicaid experience with 3 years of management 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 Masters degree in related field. 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 strategic direction across departments, actively listen to address organizational challenges, and align leaders and stakeholders through clear and actionable guidance. Ability to analyze cross-functional impacts, set clear priorities, and guide leaders to resolve high-impact challenges and improve outcomes. Ability to effectively organize work, balance cross-functional priorities, and manage team capacity across initiatives to support business objectives. 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 $135,500.00 - $182,900.00 - $230,300.00 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: talent.acquisition@bluecrossmn.com. 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.