Hedis Project Coordinator Jobs (NOW HIRING)

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'll Have Blue Cross and Blue Shield of Minnesota is looking for a Principal Program Manager to join our team.
The Principal Program Manager, Value Performance is responsible for leading the organization's annual HEDIS project, including project planning, training development, vendor and contractor onboarding, and ongoing operational oversight. This role drives performance on HEDIS hybrid and chart review measures by monitoring quality rates, identifying improvement opportunities, managing escalations, and ensuring the accuracy of clinical reviews through robust quality assurance and over-read processes. What You'll Do

The position provides leadership to a team of clinical consultants and business analysts while partnering closely with internal stakeholders, retrieval teams, and offshore vendors to achieve quality, compliance, and Star Rating performance goals. During the off-season, the Principal Program Manager maintains and updates training materials, technical specifications, workflows, and operational processes to support continuous improvement and readiness for future measurement cycles.

How You'll Do It

• Drive the development and documentation of design, requirements and implementation of multiple complex required to support initiatives that align with strategic priorities.
• Develop relationships and partner with key resources, both internal and external, to collaborate on the design and ensure all market, member, and provider considerations are factored into the design.
• Partner in the business decision making process to ensure capabilities, systems and processes meet market expectations and that alternate approaches are vetted and explored.
• Manage related ongoing program management work to understand what is needed to recommend strategy and solutions, while influencing and steering others to accomplish that strategy across multiple complex programs.
• Manage appropriate metrics, perform data analysis and evaluation for each of the initiatives.
• Develop and continually update program or project plans, timelines and deliverables while coordinating multiple sub-processes to expand and/or improve programs across multiple complex programs.
• Develop and implement a communication plan in conjunction with leadership and to support initiatives, including status and progress updates for multiple complex programs.
• Stay abreast of changes in the rapidly evolving health care marketplace.
• Performs additional responsibilities consistent with the scope and level of the role, as assigned.

Required Skills & Experience

• 7+ years of related project/program management professional experience.
• Bachelor's degree; in lieu of a degree, an additional two years of relevant experience beyond the qualifications listed above may be accepted.

Preferred Skills & Experience

• Master's degree in related field.
• Ability to translate complex information into actionable messaging, actively listen to diverse perspectives, and drive alignment across cross-functional priorities.
• Ability to analyze complex challenges, evaluate tradeoffs, and collaborate with stakeholders to reach effective, lasting solutions.
• Ability to effectively organize work, balance shifting priorities, and manage time across multiple workstreams to meet commitments.
• Healthcare or managed care experience.
• Experience managing complex projects which may involve multiple team members, task assignment, working with internal or external clients, managing teams and customer relationships, and managing project deliverables.
• Experience in data-driven decision-making.
• Process improvement (Lean / Six Sigma) experience.
• Familiarity with PM tools & Microsoft analytics tools.

Role Designation Hybrid

Role designation definition:

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

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 $102,400.00 - $138,300.00 - $174,200.00 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

• 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: 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.

Physical requirements.