Job Description

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 Manager of Provider Finance leads a team of associates in one or more core functional areas to align provider reimbursement and strategy with corporate strategic initiatives. This role allocates resources within the teams, manages projects and strategic initiatives, coaches associates in their development, facilitates operational efficiency, and fosters collaboration across the division.

Your Responsibilities

• Lead a team of associates tasked with aligning one or more core functional areas with corporate strategic direction.
• Serve as a subject matter expert to internal and external stakeholders on topics related to provider reimbursement including contract negotiations, corporate workgroups, specifically in alignment with one or more core functional areas.
• Researches, analyzes, and interprets data from internal and external sources to inform strategies for provider reimbursement & contracts
• Manages and amends relevant audit and internal control processes related to provider reimbursement and contracts.
• Conducts performance evaluation, and is responsible for managing employees, including skill and career development, policy administration, coaching on performance management and behavior, employee relations and cost control.

The Manager of Provider Finance will also have oversight for one or more of the following core functional areas:

Fee For Service Team

• Responsible for the design, development, and delivery of financial models and payment methodologies used in fee for service provider contracts and negotiations

Network Implementation Team

• Responsible for system configuration, strategic design, and auditing required to support fee for service contracts and strategic initiatives

Budgets & Settlements Team

• Responsible for the budgeting, forecasting, settlements and related reporting to support provider networks and strategic reimbursement.

Required Skills And Experience

• 5+ years of related professional experience. Experience should be in a significant role in the health plan and/or healthcare insurance industry. All relevant experience including work, education, transferable skills, and military experience will be considered.
• 3 years experience managing teams involving multiple team members including task assignment, collaborating with key customers (internal or external), managing team and customer relationships and managing project deliverables with demonstrated coaching and mentoring skills.
• Knowledge of healthcare payment methodologies and coding protocols required. This includes but is not limited to: RBRVS, MS- and APR DRGs, EAPGs/APCs, CPT/HCPCS, ICD, healthcare coding protocols and government healthcare programs.
• Specific experience with financial modeling, auditing, forecasting, and budgeting in a healthcare environment.
• Strong oral and written communication skills.
• High school diploma (or equivalency) and legal authorization to work in the U.S.

Preferred Skills And Experience

• Bachelor's degree.

Compensation And Benefits

Pay Range:

$115,000.00 - $155,300.00 - $195,600.00 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.

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.

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: talent.acquisition@bluecrossmn.com.

Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.

Job Tags

Full time, Contract work, For contractors, Work at office, 2 days per week,

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