Director of Value Submissions and Analytics

Director of Value Performance Submissions and Analytics

Join to apply for the Director of Value Performance Submissions and Analytics role at 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.

The Director of Value Performance Submissions and Analytics leads a high performing team directing and influencing risk adjustment and quality programs decision making, overseeing data and information collection, overseeing data presentations to stakeholders through reports and dashboards, and responsible for government submissions across BCBS MN’s government programs – Medicare, Medicaid, and Affordable Care Act (ACA). This position is responsible for supporting all data‑driven initiatives of our risk adjustment and quality programs to support our corporate goals, while leading, mentoring and motivating a diverse team of business and data analysts.

This director‑level role requires coordination with multiple stakeholders to implement and execute the accurate, complete, and truthful submission of data to multiple entities including vendors, third‑party data collection and submissions entities, and government bodies such as CMS, HHS, and DHS.

• Develop, lead, and provide strategic direction for a high performing team responsible for maintaining, executing, and evaluating initiative impacts using the risk adjustment and quality analytics models across ACA Commercial, Medicare, and Medicaid.
• Develop, lead, and provide strategic direction for a high performing team responsible for the execution and day-to-day management of data submissions for ACA Commercial, Medicare, and Medicaid risk adjustment and quality programs.
• Design and execute complex analytic strategies – including benchmarking, prevalence tracking, cohort stratification, predictive modeling, and suspecting logic leading to accurate risk adjustment scores and supporting quality measure gap closure.
• Direct data preparation for analytic efforts by establishing data quality and accuracy standards; approving system improvements to enhance overall quality of data; championing the resolution of critical issues as appropriate; and reviewing complex or high‑profile data sets.
• Oversee the development, implementation, and automation of business and reporting strategies by partnering with key stakeholders to ensure their design, planning, and implementation needs are being met while ensuring alignment with strategic business objectives; reviewing and approving results and roadmaps as appropriate; ensuring compliance with standards and guidelines for data reports, visualizations, and/or interactive Business Intelligence (BI) reports; and sharing insights with stakeholders on key findings.
• Direct research, analyses, and interpretation of risk adjustment and quality data and provide technical assistance to other departments including Underwriting, Government Programs, Finance, Network Management, Health Management, Sales and Marketing, Legal, and Senior Staff.
• Responsible for synthesizing complex findings into clear, compelling narratives that support strategic decision-making and stakeholder alignment.
• Review and maintain processes to assess and prevent data loss that may impact risk adjustment accuracy or quality programs.
• Engage, participate, and present in risk adjustment and quality strategic planning activities by partnering with internal stakeholders to develop strategies, goals, objectives and initiatives that align to corporate and divisional priorities.
• Provides leadership and oversight with responsibility for key employment decisions including selection, onboarding, performance management, coaching skill and career development, policy administration, employee…