Director Compliance Operations

Blue Cross Blue Shield of Minnesota•Eagan, MN

1d•Hybrid

About The Position

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 Blue Cross Blue Shield of Minnesota is hiring a Director Compliance Operations in Eagan, MN. The Director of Compliance Operations leads the design, execution, and continuous improvement of the enterprise compliance program. This role ensures adherence to federal and state regulations, industry standards, and internal policies while fostering a culture of integrity and ethical conduct. The Director is a strategic advisor and deep subject matter expert across Medicare, Medicaid, and Commercial health insurance . This role oversees the C ode of C onduct, regulatory change management, corporate policy governance, vendor risk management, regulatory reporting, licensing, and regulatory attestations , and all aspects of compliance program effectiveness . The position carries enterprise-wide responsibility and impact and drives compliance program maturity through metrics, dashboards, and disciplined operational excellence. You will bring 7+ years of healthcare compliance experience and 5+ years of people leadership, with the breadth and depth to lead an enterprise compliance program across all lines of business. You have led regulatory change management in highly regulated environments and understand how to build, operate , and mature an effective compliance program. As a visible and collaborative leader, you bring energy and strategic thinking, leverage technology and AI to drive innovation, and foster a strong culture of integrity, accountability, and compliance.

Requirements

Acceptance of this role requires signing an Employee Confidentiality, Intellectual Property Assignment, and Restrictive Covenants Agreement.
Minimum of 7 years of related and progressive experience in compliance, regulatory affairs, risk management, or legal roles within healthcare, insurance, or other highly regulated industries . All relevant experience including work, education, transferable skills, and military experience will be considered.
At least 5 years in a leadership or people management role, with proven ability to lead cross-functional teams and manage other managers.
Experience in healthcare compliance, managed care, or insurance environments.
Deep knowledge of federal, state, and industry regulations (e.g., Health Insurance Portability an d Accountability Act (H IPAA ) , C enter s for Medicare and Medicaid Services (C MS ) , state Medicaid requirements ) and best practices for compliance programs.
Demonstrated experience with Medicare, Medicaid, and Commercial programs, including regulatory filings, audits, CMS regional office relationship management and vendor oversight management.
Strong analytical, organizational, and problem-solving skills; ability to manage cyclical processes with consistency and attention to detail.
Exceptional written and oral communication skills, including presenting complex compliance issues to senior leadership and external regulators.
Strategic, enterprise-wide thinking; positive, energized presence; strong teacher and problem solver; excellent delegator and escalator.
Proficiency with compliance platforms, reporting dashboards and modern workplace tools utilizing AI.
Capacity to expand and evolve current processes to meet future needs; ability to facilitate change and lead through ambiguity.
Commitment to fostering a culture of integrity, accountability, and compliance.
Willingness to travel as needed for training or regulatory meetings.
High school diploma (or equivalency) and legal authorization to work in the U.S.; must be eligible to work in the United States without need for work visa or residency sponsorship.

Nice To Haves

Bachelor’s degree or higher degree in business, healthcare administration, public health, law, or related field.
Professional certifications such as Certified in Healthcare Compliance (CHC), Certified Compliance & Ethics Professional (CCEP), etc. ; Ongoing continuing education in compliance, regulatory affairs, or risk management.
Experience creating materials and presenting to boards, compliance committees, or regulatory bodies.

Responsibilities

Ensure enterprise-wide compliance with all regulatory requirements, internal policies, and ethical standards across all business lines.
Serve as a subject matter expert in Medicare, Medicaid, and Commercial regulations, advising executives and operational leaders.
Develop and maintain key relationships with relevant regulators , including serving as the Medicare and Medicaid Compliance Officer.
Direct the Corporate Policy Office, including policy development, review, approval, and annual Code of Conduct updates.
Lead regulatory change management, including analysis, ownership assignment, and timely implementation of new requirements.
Oversee integration of compliance controls into vendor agreements and contracting processes, pre-delegation reviews, and ensur e audit readiness and accountability.
Direct the conflict-of-interest disclosure process , exclusion screenings, and mandatory compliance training in partnership with HR.
Develop and maintain centralized compliance metrics, dashboards with Key Risk Indicators (KRIs) , and regulatory reporting for oversight bodies.
Oversee organizational licensing, regulatory attestations, certifications, and timely regulatory filings.
Lead the compliance hotline reporting and investigation function s , ensuring well documented and thorough investigations and appropriate organizational response .
Lead, develop, and mentor a high-performing compliance team, fostering a culture of integrity, collaboration, and continuous improvement.
Champion compliance efforts across the enterprise, modeling the highest standards of integrity and ethical conduct.