Government Programs Partner Relations Consultant

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.

Blue Cross and Blue Shield of Minnesota is hiring a Government Programs Partner Relations Consultant. In this role, you will serve as the primary relationship manager and consultant for contracted care coordination delegates supporting Minnesota Senior Health Options (MSHO) and Minnesota Senior Care Plus (MSC+). The role provides delegated entity oversight through performance monitoring, training, audit activities, regulatory guidance, and operational consultation to support compliance with care coordination program, contractual, and regulatory requirements.

This position collaborates with internal and external stakeholders on root cause analysis, drives performance improvement, promotes operational consistency, and strengthens care coordination delegate partnerships that support quality outcomes and member experience.

• Represent the organization on internal and external work groups. Maintain technical and regulatory MSHO and MSC+ product expertise and serve as a Blue Plus care coordination subject matter expert to internal and external partners.
• Collaborate with internal and external stakeholders to facilitate resolution of complex issues related to care coordination activities. Identify barriers, coordinate cross-functional efforts, and recommend solutions that support compliance, operational effectiveness, and quality outcomes.
• Perform responsibilities in one of the following focus areas: (a) Performance focus:
  Contribute to the development of and lead implementation of oversight frameworks, monitoring activities, escalation pathways, and corrective action processes to support compliance, risk mitigation, and delegate performance improvement. (b) Relations focus:
  Develop and maintain relationships with delegated entities through consultation, facilitation, coaching, mentoring, and education. Serve as the primary care coordination consultant, trusted advisor, and point of contact for assigned delegates, providing guidance and expertise on member-specific care coordination issues, contractual obligations, quality expectations, regulatory requirements, operational processes, performance standards, and implementation of program, policy, and process changes.

• Develop, maintain, and disseminate care coordination processes, guidance documents, FAQs, reference materials, and training resources to support regulatory compliance, standardize operational consistency, and the ongoing advancement of care coordination quality, effectiveness, and member outcomes.
• Monitor delegate operations and performance against contractual, regulatory, and organizational requirements to identify risks, improvement opportunities, and performance gaps.
• Develop and deliver delegate training programs that promote compliance, quality outcomes, operational consistency, and successful implementation of business and regulatory initiatives.
• Lead the development, maintenance, and implementation of delegate care coordination guidelines, forms, resources, process documentation, and communication tools. Identify opportunities for process standardization and operational improvements to enhance efficiency and knowledge retention.
• Solicit and evaluate feedback from delegated entities and internal stakeholders to…