Manager Clinical Enablement

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.

In this role, you will be responsible for leading a team that serves as a conduit between the clinical operations teams, product teams and technology to effectively design, develop, implement, and maintain platforms, systems, applications and processes that enable efficient and effective clinical operations. You will be responsible for ensuring that platforms, systems, applications and processes are reliable, effective, and configured to be compliant with industry standards and regulations.

In this role, you will be responsible for liaising with operations leaders and applying data-driven models to continually iterate staffing models, processes, technology, and automation to improve efficiency and clinical operations outcomes. The work of the team is highly matrixed and requires close collaboration with multiple departments including case management operations, utilization management operations, IT, data & analytics, enterprise value delivery and business partnerships & negotiations to understand needs and requirements of end‑users and stakeholders.

• Monitors system, platform and application performance over time.
• Escalates & helps remediate priority issues quickly.
• Tracks and problem solves pervasive issues to prevent long‑term impacts to business operations.
• Manages and evaluates configuration work provides feedback and coaching.
• Oversees the development and implementation of policies and procedures, performance metrics, and quality assurance standards for Medical Management platforms, systems, and applications.
• Oversees the configuration, implementation, and maintenance of the medical management software systems and applications.
• Assists the team in troubleshooting and resolving any issues or defects related to the medical management platforms, systems, and applications.
• Monitors and analyzes data and reports on the outcomes and effectiveness of medical management platforms, systems, and applications.
• Works with matrixed stakeholders including operations leaders, product managers and business partnerships & negotiations to ensure platforms, systems, and applications are robust and performing effectively to enable strategic operations goals and product roadmaps.

Continually find ways to improve processes and support clinical teams, while maintaining high quality standards including oversight of workforce management tools and deployment of automation functions. Effectively coordinate and focus the work of skilled employees toward strategic division initiatives, prioritizing work and driving incremental value. Build partnerships with matrixed internal stakeholders to facilitate collaboration and speed to delivery. Performs additional responsibilities consistent with the scope and level of the role, as assigned.

• 5+ years of progressive information technology experience, with 1+ staff, team lead or project lead experience.
• Bachelor’s degree; in lieu of a degree, an additional two years of relevant experience beyond the qualifications listed above may be accepted.

• Masters degree in related field
• Utilization Management experience.
• Ability to communicate expectations and priorities clearly to team members, actively listen to…