Director Compliance Operations

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profile Job Location:

Eagan, MN - USA

profile Yearly Salary: $ 135500 - 230300
Posted on: 7 days ago
Vacancies: 1 Vacancy

Job Summary

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 WillHave

Blue Cross Blue Shield of Minnesota is hiringa Director Compliance Operations in Eagan MN.The DirectorofCompliance Operationsleads the design execution and continuous improvement oftheenterprise compliance program. This role ensures adherence to federal and state regulations industry standards and internal policies while fostering a culture of integrity and ethical conduct. The Director is a strategic advisor and deep subject matter expert across Medicare Medicaid and Commercial health insurance. This roleoversees theCode ofConduct regulatory change management corporate policy governance vendor risk management regulatory reporting licensing and regulatory attestations and all aspects of compliance program effectiveness. The position carries enterprise-wide responsibility and impact and drives compliance program maturity through metrics dashboards and disciplined operational excellence.

You will bring 7 years of healthcare compliance experience and 5 years ofpeopleleadership with the breadth and depth to lead an enterprise compliance program across all lines of business. You have led regulatory change management in highly regulated environments and understand how to buildoperate and mature an effective compliance program. As a visible and collaborative leader you bring energy and strategic thinking leveragetechnologyand AI to drive innovation and foster a strong culture of integrity accountability and compliance.

Key Responsibilities

  • Ensure enterprise-wide compliance with all regulatory requirements internal policies and ethical standards across all business lines.

  • Serve as a subject matter expert in Medicare Medicaid and Commercial regulations advising executives and operational leaders.

  • Develop andmaintainkey relationships with relevant regulators including serving as the Medicare and Medicaid Compliance Officer.

  • Directthe Corporate Policy Office including policy development review approval and annual Code of Conduct updates.

  • Lead regulatory change management including analysis ownership assignment andtimelyimplementation of new requirements.

  • Oversee integration of compliance controls into vendor agreements and contracting processespre-delegation reviews andensureaudit readiness and accountability.

  • Directtheconflict-of-interestdisclosureprocess exclusion screenings and mandatory compliance training in partnership with HR.

  • Develop andmaintaincentralized compliance metrics dashboardswith Key Risk Indicators (KRIs) and regulatory reporting for oversight bodies.

  • Oversee organizational licensing regulatory attestations certifications andtimelyregulatory filings.

  • Leadthe compliancehotline reporting andinvestigationfunctions ensuringwell documented and thorough investigationsandappropriate organizationalresponse.

  • Lead develop and mentor a high-performing compliance team fostering a culture of integrity collaboration and continuous improvement.

  • Champion complianceeffortsacross the enterprisemodelingthe highest standards ofintegrity and ethical conduct.

Qualifications Required Skills & Experiences

  • Acceptance ofthisrole requires signing an Employee Confidentiality Intellectual Property Assignment and Restrictive Covenants Agreement.

  • Minimum of7years of related and progressive experience in compliance regulatory affairs risk management or legal roles within healthcare insurance or other highly regulated industries. All relevant experience includingwork education transferable skills and military experiencewill beconsidered.

  • At least 5 years in a leadership or people management role with proven ability to lead cross-functional teams and manageothermanagers.

  • Experience in healthcare compliance managed care or insurance environments.

  • Deep knowledge of federal state and industry regulations (e.g.Health Insurance Portability and Accountability Act (HIPAA) Centersfor Medicare and Medicaid Services (CMS)state Medicaid requirements) and best practices for compliance programs.

  • Demonstrated experience with Medicare Medicaid and Commercial programs including regulatory filings auditsCMS regional office relationshipmanagementand vendoroversightmanagement.

  • Strong analytical organizational and problem-solving skills; ability to manage cyclical processes with consistency and attention to detail.

  • Exceptional written and oral communication skills including presenting complex compliance issues to senior leadership and external regulators.

  • Strategic enterprise-wide thinking; positive energized presence; strong teacher and problem solver; excellent delegator and escalator.

  • Proficiencywith compliance platforms reportingdashboardsand modern workplace toolsutilizingAI.

  • Capacity to expand and evolve current processes to meet future needs; ability tofacilitatechange and lead through ambiguity.

  • Commitment to fostering a culture of integrity accountability and compliance.

  • Willingness to travel as needed for training or regulatory meetings.

  • High school diploma (or equivalency) and legal authorization to work in the U.S.; must be eligible to work in the United States without need for work visa or residency sponsorship.

Preferred Skills & Experiences

  • Bachelorsdegreeor higherdegree in business healthcare administration public health law or related field.

  • Professional certifications such as Certified in Healthcare Compliance (CHC) Certified Compliance & Ethics Professional (CCEP)etc.;Ongoing continuing education in compliance regulatory affairs or risk management.

  • Experiencecreating materials andpresentingto boards compliance committees or regulatory bodies.

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.

Compensation and Benefits

$135500.00 - $182900.00 - $230300.00 Annual

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.


Required Experience:

Director

About Blue Cross and Blue Shield of MinnesotaAt 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 ...
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