Senior Medical Policy Research Consultant

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.

As a member of the Medical Policy Team, the Senior Medical Policy Research Consultant is responsible for participating in development of medical policy strategy and research. This role researches and analyzes medical literature, clinical practice guidelines, and federal and state coverage decisions to develop medical policies for BCBSM and our national business. It also researches new technologies and reviews existing technologies for presentation to internal technology assessment groups, BCBSM committees, and external stakeholders when applicable.

• Develop medical policies for BCBSMN and ensure that changes in medical policies and supporting rationale are communicated to all lines of business, including Medicare and internal stakeholders.
• Present medical policy recommendations and supporting rationale to BCBSMN’s Medical and Behavioral Health Policy Committee, Coverage Committee (executive-level committee), and other key groups.
• Participate as a team member in internal BCBSMN technology assessment committees.
• Serve as an internal consultant to Medical Directors and staff on emerging medical technology issues.
• Serve as an external consultant to providers, vendors, manufacturers, government agencies, and other organizations on technology evaluation and medical policy processes.
• Participate in BCBSMN efforts to respond to regulatory and accreditation requirements (e.g., NCQA accreditation).
• Research and analyze scientific literature and medical policies around a clinical field to develop an organized, strategic approach that incorporates business integration into the policy development process.
• Manage medical policy‑related projects.

• 5+ years of related professional experience.
• All relevant experience including work, education, transferable skills, and military experience will be considered.
• Knowledge of medical literature and technology assessment evaluation methods.
• Demonstrated ability to analyze findings from the current medical literature and develop written conclusions regarding medical technology assessment in the areas of clinical effectiveness, measurable health outcomes, and safety and appropriateness.
• Knowledge of local and national health‑care environment and trends.
• Ability to work independently and deliver a defensible product before internal and external stakeholders.
• Ability to effectively communicate research results to multiple audiences in both verbal and written forms.
• Excellent interpersonal skills and the ability to build and maintain relationships with internal stakeholders, clinicians, regulatory agencies, and others.
• Project management experience.
• High school diploma (or equivalency) and legal authorization to work in the U.S.

• Bachelor’s or Master’s degree in a health‑related field with 5 years of experience working in a health‑care environment (e.g., health‑care policy or clinical guidelines development).
• Knowledge of CPT and ICD‑9 coding helpful.

Hybrid—Anchored in Connection. Our hybrid approach balances 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.

Annual pay ranges from $90,800.00 to $, based on factors such as skill level, experience, and the specific responsibilities of the position. A comprehensive benefits package may include medical, dental, and vision insurance; life insurance; 401(k); paid time off (PTO);…