Principal Program Manager

Blue Cross Blue Shield of Minnesota•Eagan, MN

15d•Hybrid

About The Position

Blue Cross and Blue Shield of Minnesota is looking for a Principal Program Manager to join our team. The Principal Program Manager, Value Performance is responsible for leading the organization's annual HEDIS project, including project planning, training development, vendor and contractor onboarding, and ongoing operational oversight. This role drives performance on HEDIS hybrid and chart review measures by monitoring quality rates, identifying improvement opportunities, managing escalations, and ensuring the accuracy of clinical reviews through robust quality assurance and over-read processes. The position provides leadership to a team of clinical consultants and business analysts while partnering closely with internal stakeholders, retrieval teams, and offshore vendors to achieve quality, compliance, and Star Rating performance goals. During the off-season, the Principal Program Manager maintains and updates training materials, technical specifications, workflows, and operational processes to support continuous improvement and readiness for future measurement cycles.

Requirements

7+ years of related project/program management 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.

Nice To Haves

Master's degree in related field.
Ability to translate complex information into actionable messaging, actively listen to diverse perspectives, and drive alignment across cross-functional priorities.
Ability to analyze complex challenges, evaluate tradeoffs, and collaborate with stakeholders to reach effective, lasting solutions.
Ability to effectively organize work, balance shifting priorities, and manage time across multiple workstreams to meet commitments.
Healthcare or managed care experience.
Experience managing complex projects which may involve multiple team members, task assignment, working with internal or external clients, managing teams and customer relationships, and managing project deliverables.
Experience in data-driven decision-making.
Process improvement (Lean / Six Sigma) experience.
Familiarity with PM tools & Microsoft analytics tools.

Responsibilities

Drive the development and documentation of design, requirements and implementation of multiple complex required to support initiatives that align with strategic priorities.
Develop relationships and partner with key resources, both internal and external, to collaborate on the design and ensure all market, member, and provider considerations are factored into the design.
Partner in the business decision making process to ensure capabilities, systems and processes meet market expectations and that alternate approaches are vetted and explored.
Manage related ongoing program management work to understand what is needed to recommend strategy and solutions, while influencing and steering others to accomplish that strategy across multiple complex programs.
Manage appropriate metrics, perform data analysis and evaluation for each of the initiatives.
Develop and continually update program or project plans, timelines and deliverables while coordinating multiple sub-processes to expand and/or improve programs across multiple complex programs.
Develop and implement a communication plan in conjunction with leadership and to support initiatives, including status and progress updates for multiple complex programs.
Stay abreast of changes in the rapidly evolving health care marketplace.
Performs additional responsibilities consistent with the scope and level of the role, as assigned.