Government Programs Partner Relations 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.

The Impact You'll Have

What You'll Do

• Represent the organization on internal and external work groups. Maintain technical and regulatory MSHO and MSC+ product expertise and serve as a BluePlus 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.

How You'll Do It

• 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 identify opportunities for enhancing delegate support, strengthening partnerships, improving service delivery, and promoting continuous improvement in care coordination programs.
• Performs additional responsibilities consistent with the scope and level of the role, as assigned

Required Skills & Experience

• 5+ years of related Medicare / Medicaid professional experience.
• Bachelor’s degree; in lieu of a degree, an additional two years of relevant experience beyond the qualifications listed above may be accepted.
• Ability to travel.

Preferred Skills & Experience

• 5+ years of experience in care coordination.
• 3+ years of experience developing and maintaining relationships with external partners, providers, delegates, vendors, or other healthcare stakeholders.
• Knowledge of government healthcare programs, regulations, and compliance requirements.
• Knowledge of health plan operations, products, and business practices.
• Experience improving processes, workflows, or operational performance.
• Ability to communicate complex topics clearly and concisely, actively listen to anticipate stakeholder needs, and align others to drive informed decisions.
• Ability to analyze complex information, evaluate options, and work cross-functionally to drive resolution and prevent recurrence.
• Ability to effectively organize work, balance competing priorities, and manage time across complex assignments and competing deadlines.

Licensure/Certifications

Role Designation

Role designation definition:

• Teleworking is working full time remote.
• Hybrid is a minimum of 2 days onsite.
• Onsite is full-time onsite.

Anchored in Connection

Our hybrid approach is designed to balance 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.

Compensation and Benefits

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

• Medical, dental, and vision insurance

• Life insurance

• 401k

• Paid Time Off (PTO)

• Volunteer Paid Time Off (VPTO)

• And more

To discover more about what we have to offer, please review our benefits page.

Equal Employment Opportunity Statement

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic.

Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talent.acquisition@bluecrossmn.com.

Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.

Physical requirements.