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 Vice President of Medicare owns the growth and revenue strategy and execution. Serves as an executive leader for Medicare and Value Performance helping guide and support the organizations overall direction.

This executive will be a market leader who represents the Medicare business in the market and develops relationships that support growth distribution and partnership strategies. This individual is accountable for the P&Ls of Medicare plans with a strong focus on achieving membership and operating margin performance. The VP will develop execute and manage the product strategy end-to-end performance management and overall strategic plan objectives for existing and future expansions of the Medicare addition to leading the Medicare P&L the VP will drive cross-enterprise influence to ensure quality and risk adjustment strategic goals are delivered upon in all lines of business.

Your Responsibilities

• Full P&L responsibility for Medicare including attainment of profit and loss revenue membership enrollment and retention market share quality ratings (HEDIS Stars etc.) medical and administrative expense targets as well as member services SLAs regulatory and compliance requirements (NCQA) for each market segment.

• Develop and execute short- and long-term strategic plans that drive growth and performance of Medicare Markets. A main focus of role is to create a sustainable and stable Medicare Advantage program.

• Influence activities for Star improvement and risk adjustment optimization to ensure that the maximum benefit is derived with minimized provider and member abrasion.

• Foster strong local relationships (e.g. regulators navigators/enrollment assistors). Maximize Medicare value proposition through partnerships with key matrix organizations (network contracting medical management distribution account management product etc.).

• Collaborate with internal business functions (Finance Actuarial Quality & Member Experience Population Health Management Enrollment Operations Marketing Provider Partnerships Legal IT etc.) to execute on performance management and improvement initiatives for the Medicare markets. Jointly develop performance metrics with internal colleagues that help hold the organization accountable in a collaborative and productive manner.

• Foster strong partnership with marketing and community relations teams to ensure adequate lead generation to drive sales timely and effective communications with members and provider partners in line with CMS requirements and guidelines and positive brand awareness building in order to promote active selection among eligible populations. Builds and maintains relationships with senior advocacy groups.

• Communicates clearly and persuasively to build support for initiatives engaging both internal and external stakeholders.

• Manages and guides direct reports and the division toward accountable goal-oriented outcomes aligned with enterprise strategy.

Required Skills and Experience

• Accepting this position at BCBSMN requires signing an Employee Confidentiality Intellectual Property Assignment and Restrictive Covenants Agreement as a condition of employment.

• Minimum of a bachelors degree in business healthcare or related field equivalent experience.

• 10 years in market management product management or segment strategy role Medicaid or Medicare.

• 7 years owning and managing P&L in healthcare or 5 years minimum P&L ownership in Medicare.

• 3 years market leadership within assigned market(s) strongly preferred in Medicare business with deep knowledge of Star/Quality and Risk adjustment programs.

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

Preferred Skills and Experience

• Demonstrated track record of ownership and achievement of bottom-line results by managing well-crafted strategic plans.

• Demonstrated experience leading/owning membership / financial forecasting.

• Developed expertise in Contracting Product Provider Relations and Medical Management such that incumbent can leverage support needed to deliver the right customer solution.

• Proven experience analyzing competitors products distribution systems administrative and service capabilities as well as marketing plans and strategies to anticipate the market and external influences. Solutions-orientation with constant focus defining and executing on the what to strengthen and improve the business and assigned market performance.

• A team player with experience building strong relationships both internally and externally and with a strong sense of self-initiative and desire to succeed. Proven leadership influencing and negotiation skills in a highly matrixed environment.

• Must have strong analytical communication interpersonal and presentation skills.

• Comfortable dealing with and managing an ever-changing highly competitive industry/ environment; communicates optimism and confidence in the future.

• Able to make sound assumptions and is comfortable working in situations where data is incomplete or limited (problem solving).

• Entrepreneurial thinking skills with strong customer focus and team orientation

Role Designation

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

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.