Director of Value Performance Quality

Director of Value Performance Quality

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 organization's 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 organization's 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

Compensation and Benefits

Pay Range : $132,300.00 - $224,900.00 Annually

We offer a comprehensive benefits package which may include :

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

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.

Equal Employment Opportunity Statement

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