Director of Value Performance Quality

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 Will Have

The Director of Value Performance Quality provides strategic and operational leadership for all enterprise quality performance programs across the organizations Medicare Medicaid ACA and Commercial lines of business. This position leads the design implementation and oversight of initiatives that directly impact reportable quality measures ratings and financial performance while ensuring alignment with regulatory requirements financial objectives and organizational strategy. The Director oversees programs such as Medicare Stars HEDIS CAHPS / HOS and other quality measures that are required by regulation or contract. They ensure that quality initiatives are data-driven well-governed and effectively executed enabling the organization to achieve excellence in quality outcomes maintain compliance with quality reporting requirements and optimize member experience and value. Success in this position directly influences the organizations quality ratings bonus revenues benefit design flexibility and overall reputation for delivering value to members. The Director serves as a visible leader and trusted advisor to executive leadership driving enterprise collaboration to achieve quality excellence.

Your Responsibilities

• Lead the strategic direction for enterprise quality programs that impact reportable measures across Medicare Medicaid ACA and Commercial lines of business including Medicare Stars HEDIS CAHPS / HOS and other regulatorily required quality programs.
• Develop and execute an enterprise quality roadmap that integrates measurement analytics reporting and intervention strategies to drive performance improvement.
• Partner with senior leadership to set performance goals align incentives and communicate results that link quality outcomes to organizational priorities.
• Leverage data and analytics to forecast performance monitor progress and identify risks and opportunities for improvement.
• Collaborate with Pharmacy Risk Adjustment Network Management Care Management Member Experience Medical Management Sales Product Development Underwriting Actuarial Finance Government Programs Operations and other departments to align strategies and initiatives that drive measurable gains in performance.
• Translate CMS NCQA and other regulatory quality requirements into actionable strategies to operationalize across departments.
• Provide executive-level reporting and communication on quality performance to governance bodies and senior leadership translating complex metrics into clear insights and recommendations.
• Foster a culture of performance excellence transparency and continuous improvement throughout the organization.
• Act as a strategic leader driving innovation and evolution in quality programs ensuring readiness for regulatory and technical changes.
• Direct the Value Performance Quality team ensuring accountability alignment and consistency in execution including employment decisions onboarding and team development. Conducts performance evaluation and is responsible for managing employees including skill and career development policy administration coaching on performance management and behavior employee relations and cost control.

Required Skills and Experience

Preferred Skills and Experience

Role Designation

Hybrid

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

$132300.00 - $178600.00 - $224900.00 Annual

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 :

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

Required Experience :

Director

Key Skills

Crisis Management,Marketing,Public Relations,Fundraising,Media Relations,Constant Contact,Strategic Planning,Social Media Management,Team Management,Public Speaking,Wordpress,Writing Skills

Employment Type : Full-Time

Experience : years

Vacancy : 1

Yearly Salary Salary : 132300 - 224900