Manager, Accreditation Manager

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.

Blue Cross and Blue Shield of Minnesota is looking for a Manager Accreditation Manager to join our team. This role leads and oversees accreditation program activities that support organizational compliance quality performance and survey readiness across multiple lines of business. The Manager Accreditation Manager is responsible for planning and executing complex accreditation initiatives ensuring ongoing compliance with NCQA standards and successfully guiding the organization through the full accreditation lifecycle including survey preparation documentation management evidence collection file review coordination and survey submission.

Working closely with cross-functional leaders and business owners this role interprets accreditation requirements provides training and consultative guidance on standard implementation and helps develop processes policies and procedures that align with accreditation expectations. The position manages accreditation-related risks monitors compliance activities coordinates readiness assessments and oversees documentation and reporting to support successful survey outcomes.

Through strong collaboration relationship management and expertise in accreditation quality improvement HEDIS CAHPS utilization management credentialing and complex care management programs this role drives organizational performance strengthens compliance and supports the achievement and maintenance of accreditation standards.

• Collaborate with leadership to design and implement practices processes and tools that support accreditation strategy compliance and readiness.
• Plan direct and coordinate projects associated with the departments accreditation strategy.
• Develop enterprise reporting and coordinate documentation of accreditation compliance to support oversight reporting and formal accreditation survey submissions.
• Manage an accreditation team with accountability for the full associate lifecycle including workforce decisions performance and talent management employee relations policy compliance and cost control.

• Leverage organizational knowledge and business acumen to develop effective cross-functional teams and lead through influence to successfully complete projects.
• Identify accreditation compliance issues and risks and escalate both concerns and potential solutions appropriately.
• Maintain appropriate project documentation to support accreditation oversight reporting and readiness.
• Communicate consult and support implementation of accreditation requirements to ensure compliance issues are addressed and projects are completed according to established guidelines.
• Research and stay current on accreditation related emerging business and technology trends/issues/topics within the healthcare industry the Blues System and the Minnesota market.
• Performs additional responsibilities consistent with the scope and level of the role as assigned.

• 5 years of progressive medical care management experience with 1 staff team lead or project lead experience.

• Bachelors degree; in lieu of a degree an additional two years of relevant experience beyond the qualifications listed above may be accepted.

• Masters degree in related field

• Healthcare experience and/or knowledge of the managed care and health care/insurance industry.

• Experience with accreditation and/or compliance regulations for clinical programs.

• Experience managing complex/multiple projects simultaneously.

• Process improvement and ability to implement tools or systems that improve team efficiency and accuracy.

• Demonstrated experience with policy development formal writing and reporting.

• Ability to build and maintain relationships with internal and external stakeholders clinicians and others.

• Strong documentation and workflow process skills.

• Knowledge of medical terminology and procedures.

• Understanding of medical claims and coding.

• Ability to communicate expectations and priorities clearly to team members actively listen to resolve issues and remove barriers and drive alignment across teams and stakeholders.

• Ability to analyze department challenges guide team decision-making and collaborate across teams to drive resolution and next steps.

• Ability to effectively organize team work balance priorities across projects and manage time and resources to ensure timely delivery and coordination.

Teleworker

Role designation definition:

• Teleworking is working full time remote.
• Hybrid is a minimum of 2 days onsite.
• Onsite is full-time onsite.

$102400.00 - $138300.00 - $174200.00 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.

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.

Physical requirements.