The Impact You Will Have

Blue Cross and Blue Shield of MN is hiring aManager of Government Submissions. The Manager of Government Submissionsleads a high performing team responsible for government submissions across BCBS MNs government programs - Medicare Medicaid and Affordable Care Act (ACA). This positionis responsible forsupporting all data-driven initiatives concerning government submissions including our risk adjustment and quality programswhile leading mentoring and motivating a diverse team of business and data analysts. This role requires coordination with multiple stakeholders to implement and execute theaccurate complete and truthful submission of data to multiple entities including vendors performing activities or analyses on our behalf third-party data collection and submissions entities and government bodies such as CMS HHS and DHS.

The ideal candidate has5 years ofGovernment Submissions experience and at least 3 years of directpeopleleadershipexperience. This individual will have significant Medicare experience as a core requirement with broader experience across Medicaid and ACA preferred and a solid understanding of healthcare data. This role requires hands-on experience with SQL Power BI and encounter data submissions. Strong leadership problem-solving communication and collaboration skills are essential to support teams and ensure compliance in a fast-paced regulated environment.

Your Responsibilities

• Develop lead and provide strategic direction for a high performing team responsible for the execution and day-to-day management of data submissions for ACA Commercial Medicare and Medicaid risk adjustment and quality programs.

• Oversee the development implementation and automation of business and reporting strategies concerning government submissions by partnering with key stakeholders to ensure their design planning and implementation needs are being met while ensuring alignment with strategic businessobjectives.

• Directresearch analysis and interpretation of risk adjustment and quality data and provide technicalassistanceto other departments including Underwriting Government Programs Finance Network Management Health ManagementSalesand Marketing Legal and Senior Staff.

• Responsible for synthesizing complex findings into clear compelling narratives that support strategic decision-making and stakeholder alignment.

• Review andmaintainprocesses to assess and prevent data loss that mayimpactriskadjustmentaccuracy or quality programs.

• Engageparticipate and present in risk adjustment and quality strategic planning activities by partnering with internal stakeholders to develop strategies goalsobjectivesand initiatives that align to corporate and divisional priorities.

• Manage the departmentinterviewingandhiringemployees following required EEO and Affirmative Action guidelines and ensure employees receive the proper training.

• Conduct performance evaluation andis responsible formanaging employees including skill and career development policy administration discipline employeerelationsand cost control.

Required Skills and Experience

• 5 years of related professional experience with 3 years of management experience. All relevant experience including work education transferable skills and military experience will be considered.

• Excellent knowledge of Medicare Advantage and/or the ACA marketplace and understanding of CMS initiatives and reasoning.

• Expert level knowledge of SQL Server SSIS SSRS.

• Expert level knowledge of MS Access Excel PowerPoint and MS Word.

• Strong knowledge of data visualization software.

• Exceptional creative thinking problem-solving and critical thinking skills.

• Strong data analysis skillsincludingabilityto analyze and interpret data using SQL or comparable data tools and develop strategic recommendations.

• Excellent communication collaboration consultation presentation and interpersonal skills.

• Clearly and effectively communicates technical concepts issues and solutions to non-technical audiences.

• Ability to lead others and build relationships.

• Demonstrated delegation and management skills.

• High school diploma (or equivalency) and legal authorization to work in the U.S.

Preferred Skills and Experience:

• Bachelors degree in Finance Mathematics Computer Science Health Science or Data Science.

• Experience leading Risk Adjustment submission teams ina Healthinsurance companies Healthcare providers Healthcare technology add regulators (CMS department of healthetc) and consulting companies.

• Experience leading HEDIS data collection and submissions.

• Knowledge of statistical software (R or SAS).