Blue Cross and Blue Shield of Minnesota
Senior Provider Performance Clinical Consultant
Blue Cross and Blue Shield of Minnesota, Eagan, Minnesota, United States
Senior Provider Performance Clinical Consultant
Join to apply for the Senior Provider Performance Clinical Consultant role at Blue Cross and Blue Shield of Minnesota 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
This role is a key element in supporting providers' success in value-based agreements across all lines of business. The role works in tandem with the Manager of Clinical Consultation, Provider Performance Clinical Consultants, and the Medical Director to review provider-specific data and identify actionable clinical opportunities. The role leads face-to-face meetings with leaders in provider care systems and is responsible for forming partnerships with providers to develop and execute provider-specific action plans to improve health care cost/utilization trends. Your Responsibilities
Point on advising and leading consultative conversations with provider groups about opportunities to improve clinical and cost/utilization trends. Develop and execute provider-specific action plans for care systems with value-based agreements that are early in the path to risk (less complex, upside-only models). Contribute to the design of provider-facing clinical consultation tools, processes, and supporting resources to support providers early in their path to risk. Facilitate discussion of opportunities identified based on review of value-based cost and utilization performance data in provider-facing meetings. Work closely with Medical Director and Manager of Clinical Consultation to review data and identify provider-specific opportunities. Advise on business needs to provider-performance data owners to ensure reporting meets the needs of clinical consultation and oversight conversations with providers. Required Skills And Experiences
5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered. Possess relevant degree or extensive experience in healthcare, clinical care, or public health. Excellent executive presence. Collaborative, interpersonal, verbal and written communication skills and demonstrated ability to develop accurate and appropriate communication to all levels of management. Demonstrated track record of achievement with ability to influence change and identify customer expectations, barriers, and issues. Creative problem-solving skills, adapting approach as needed. Excellent facilitation and relationship building skills. Demonstrated ability to work independently and make decisions as needed. Expert level ability to make decisions based on analysis and business needs. Exceptional ability to work in high-paced environment, handling multiple responsibilities and projects. High school diploma (or equivalency) and legal authorization to work in the U.S. Preferred Skills And Experiences
Bachelor's degree Experience with value-based payment arrangements Compensation And Benefits
Pay Range:
$88,600.00 - $117,400.00 - $146,200.00 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 PTO Volunteer Paid Time Off (VPTO) And more 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 a week—one designated anchor day with your team, and one day of your choosing. 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. Seniority level
Mid-Senior level Employment type
Full-time Job function
Research, Analyst, and Information Technology Industries
Insurance
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Join to apply for the Senior Provider Performance Clinical Consultant role at Blue Cross and Blue Shield of Minnesota 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
This role is a key element in supporting providers' success in value-based agreements across all lines of business. The role works in tandem with the Manager of Clinical Consultation, Provider Performance Clinical Consultants, and the Medical Director to review provider-specific data and identify actionable clinical opportunities. The role leads face-to-face meetings with leaders in provider care systems and is responsible for forming partnerships with providers to develop and execute provider-specific action plans to improve health care cost/utilization trends. Your Responsibilities
Point on advising and leading consultative conversations with provider groups about opportunities to improve clinical and cost/utilization trends. Develop and execute provider-specific action plans for care systems with value-based agreements that are early in the path to risk (less complex, upside-only models). Contribute to the design of provider-facing clinical consultation tools, processes, and supporting resources to support providers early in their path to risk. Facilitate discussion of opportunities identified based on review of value-based cost and utilization performance data in provider-facing meetings. Work closely with Medical Director and Manager of Clinical Consultation to review data and identify provider-specific opportunities. Advise on business needs to provider-performance data owners to ensure reporting meets the needs of clinical consultation and oversight conversations with providers. Required Skills And Experiences
5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered. Possess relevant degree or extensive experience in healthcare, clinical care, or public health. Excellent executive presence. Collaborative, interpersonal, verbal and written communication skills and demonstrated ability to develop accurate and appropriate communication to all levels of management. Demonstrated track record of achievement with ability to influence change and identify customer expectations, barriers, and issues. Creative problem-solving skills, adapting approach as needed. Excellent facilitation and relationship building skills. Demonstrated ability to work independently and make decisions as needed. Expert level ability to make decisions based on analysis and business needs. Exceptional ability to work in high-paced environment, handling multiple responsibilities and projects. High school diploma (or equivalency) and legal authorization to work in the U.S. Preferred Skills And Experiences
Bachelor's degree Experience with value-based payment arrangements Compensation And Benefits
Pay Range:
$88,600.00 - $117,400.00 - $146,200.00 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 PTO Volunteer Paid Time Off (VPTO) And more 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 a week—one designated anchor day with your team, and one day of your choosing. 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. Seniority level
Mid-Senior level Employment type
Full-time Job function
Research, Analyst, and Information Technology Industries
Insurance
#J-18808-Ljbffr