Shield Compliance Jobs (NOW HIRING)

The Impact you will have

Blue Cross and Blue Shield of Minnesota is hiring a Manager, Compliance Oversight in Eagan, MN. The Manager, Compliance Oversight will lead a team responsible for conducting compliance assessments and monitoring activities across internal operations and external partners, including First Tier, Downstream, and Related Entities (FDRs) and subcontractors supporting Medicare, Medicaid, and ACA programs. This leader will manage risk-based reviews and assessments designed to identify compliance risks, validate controls, and ensure adherence to regulatory requirements. The manager also ensures adherence to regulatory requirements, drives corrective actions, and provides strategic compliance guidance to business and vendor stakeholders. This role also shapes and advances monitoring practices, partners across the organization, and ensures compliance risks are identified, addressed, and reported effectively. The role also plays a key part in strengthening oversight frameworks and fostering a culture of accountability and continuous improvement.

The ideal candidate brings 7+ years of audit and compliance experience, including leading compliance assessments, audits, monitoring programs, or regulatory reviews, along with 3+ years of people leadership. They are a strong critical thinker who can interpret regulations, assess organizational risk, manage multiple concurrent assessments, and operate effectively in evolving, ambiguous environments. Experience with Medicare, Medicaid, and ACA programs is highly valued, along with strong skills in relationship-building, project management, change leadership, and team development.

Your Responsibilities

• Lead ongoing monitoring of internal and external operations, including targeted deep dives into FDR/Subcontractor oversight activities.

• Ensure compliance with enterprise standards and regulatory requirements.

• Plan and execute internal and external compliance assessments across all lines of business.

• Provide consultative support for external regulatory audits, including guidance on regulatory requirements and review of documentation prior to submission.

• Initiate and approve Corrective Action Plans (CAPs), as well as validate implementation and effectiveness.

• Prepare and maintain records for reporting to EEC Leadership, enterprise-wide leadership, EEC Committee Members, Board of Directors, and external regulators.

• Provide regulatory guidance and consultative support to business units and vendor managers.

• Guide, mentor and train staff supporting compliance deliverables, and foster a culture of compliance awareness and continuous improvement.

Required skills and experiences

• Seven or more years' experience in compliance. All relevant experience including work, education, transferable skills, and military experience will be considered.

• Three or more years in a leadership or people management role, with proven ability to lead cross-functional teams.

• Experience in healthcare compliance, managed care, or insurance environments.

• Deep knowledge of federal, state, and industry regulations (e.g., HIPAA, Joint Commission, CMS, CLIA) and best practices for compliance programs.

• Strong analytical, organizational, and problem-solving abilities, including risk assessment and corrective action planning.

• Exceptional written and verbal communication skills for presenting complex compliance issues to leadership and regulators.

• Demonstrated expertise with Medicare, Medicaid, and Commercial programs, including monitoring, audits, or vendor management oversight.

• Effective team leadership, teaching, and delegation skills; fosters a positive, accountable, and compliant culture.

• Strategic, enterprise-wide thinking and ability to drive execution through relationships.

• Ability to facilitate change, promote continuous improvement, and lead through ambiguity.

• Able to travel if needed for audits, 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 and experiences

• Bachelor's degree in business, healthcare administration, public health, law, or a related field.

• Certified in Healthcare Compliance (CHC), Certified Compliance & Ethics Professional (CCEP), or similar credential preferred.

• Continuing education in compliance, regulatory affairs, or risk management is strongly encouraged.

• CAP Expertise. Proven track record in developing, implementing, and validating corrective action plans (CAPs).

• Technology Skills. Familiarity with compliance analytics, audit software, and enterprise risk management platforms.

• Board or Committee Experience. Experience presenting to boards, compliance committees, or regulatory bodies.