Manager of HEDIS Program Management

Blue Cross Blue Shield of Minnesota•Eagan, MN

9d•Hybrid

About The Position

This position is responsible for the strategic design, development, implementation, evaluation, and ongoing management of programs that improve the delivery of health care services and drive better outcomes for our members. The role will focus specifically on leading the organization’s strategy for HEDIS® performance, including overseeing medical record retrieval, abstraction operations, and advancing enterprise capabilities for ECDS. The incumbent will work closely with leadership and cross‑functional teams to shape and execute strategies that support organizational and divisional priorities. This includes ensuring program designs meet existing and emerging market, provider, and member requirements; resolving complex business challenges; identifying and shaping new opportunities; and supporting effective change management. The role serves as a liaison between multiple internal departments and requires the ability to lead teams across the organization, drive results within tight deadlines, and manage program management associates within the division.

Requirements

7+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
1 year of management experience, leading a team
Demonstrated organizational relationship management skills.
Ability to thrive in ambiguity.
Strong critical thinking skills and problem solving/conflict resolution skills.
Excellent written and verbal communication skills with strong facilitation, negotiation and presentation skills, adapting approach as needed.
Attention to detail and time management skills.
Self-motivated, ability to work independently, and demonstrated ability to work under tight time frames.
Knowledge of the health care industry, payer business models, business segments and products.
Proven ability to handle a variety of assignments in a fast paced and complex business environment.
Proven ability to define problems, collect and analyze data, establish facts and draw valid conclusions.
High school diploma (or equivalency) and legal authorization to work in the U.S.

Nice To Haves

Bachelor’s degree in Business, Health Science or related field or Master’s degree in business, nursing, public health, health sciences, health promotion or related field.
Experience in process improvement.
Content expertise in the reduction of health risk behavior.
Ability to combine traditional health education approaches with policy or other advocacy tactics.

Responsibilities

Drive the development and documentation of design, requirements and implementation required to support initiatives that align with strategic priorities.
Develop relationships and partner with key resources, both internal and external, to collaborate on the design and ensure all market, member, and provider considerations are factored into the design.
Drive business decision making process to ensure capabilities, systems and processes meet market expectations and that alternate approaches are vetted and explored.
Manage related ongoing program management work to understand what is needed to recommend strategy and solutions, while influencing and steering others to accomplish that strategy across multiple complex programs.
Ensure that appropriate metrics are chosen and that the appropriate measurement, data analysis and evaluation occur for each initiative.
Develop and continually update program or project plans, timelines and deliverables while coordinating multiple sub-processes to expand and/or improve complex programs.
Develop and implement a communication plan in conjunction with leadership and to support initiatives, including status and progress updates.
Stay abreast of changes in the rapidly evolving health care marketplace and in regulatory or quality‑measurement programs .
May perform other duties as assigned.