Director Core Services - Medicaid

Blue Cross Blue Shield of Minnesota•Eagan, MN

1d•Hybrid

About The Position

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 As the Medicaid Core Services Leader, you serve as the primary liaison between Blue Cross and Blue Shield of Minnesota and the Minnesota Department of Human Services (DHS) for public services programs and other key stakeholders. This role is accountable for Care Coordination, Transportation, and future services contract performance and regulatory compliance across Medicaid programs. You will shape and lead initiatives that enhance P&L performance, build strong partner relationships, improve operational excellence, and continuously improve role and team impact to deliver an exceptional member experience, ensuring continued market share and profitability.

Requirements

7+ years of progressive Medicaid experience with 3+ years of management experience.
Bachelor’s degree; in lieu of a degree, an additional two years of relevant experience beyond the qualifications listed above may be accepted.

Nice To Haves

Masters degree in related field.
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 strategic direction across departments, actively listen to address organizational challenges, and align leaders and stakeholders through clear and actionable guidance.
Ability to analyze cross-functional impacts, set clear priorities, and guide leaders to resolve high-impact challenges and improve outcomes.
Ability to effectively organize work, balance cross-functional priorities, and manage team capacity across initiatives to support business objectives.

Responsibilities

Acts as the primary point of contact and liaison with DHS and other state agencies for execution of Medicaid product contracts.
Directs all activities related to Government Programs products (PMAP, MNCare, MSC+, MSHO).
Builds and maintains strategic relationships across the enterprise and with state government as customer and regulator.
Oversees contract management with DHS and CMS, with accountability for regulatory compliance.
Manages benefits contract negotiations, requirements gathering, configuration, and issue analysis.
Manages care coordination delegate programs with accountability for audit outcomes, financial performance, and value-based contract adherence.
Leads participation in Public Program contract negotiations and new program development.
Allocating resources and setting team priorities.
Accountable for the full associate lifecycle, including workforce decisions, performance and talent management, employee relations, policy compliance, and cost control.
Performs additional responsibilities consistent with the scope and level of the role, as assigned.