Senior Medical Affairs Compliance Analyst

1 month ago

Eagan, United States Blue Cross and Blue Shield of Minnesota Full time
About Blue Cross

Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We’re committed to reinventing health care to improve health for our members and the community. We hope you'll join us.

How Is This Role Important to Our Work?


This position is responsible for ensuring that Medical Affairs and IHM operations are in accreditation, regulatory, legal and contract compliance, and that these and other requirements are communicated, implemented and monitored.

A Day in the Life:

  • Monitors and analyzes new and modified accreditation standards, state and federal laws, regulations, and contract developments impacting IHM and Medical Affairs operations to determine impact on current operations and work flows.
  • Researches compliance impact and communicates new requirements and recommendations to management.
  • Develops and maintains IHM policies and procedures to support compliance with applicable laws and accreditation standards.
  • Monitors key business processes to ensure compliance, develops compliance reports and other process improvement documents, and presents reports, trends and recommendations to key stakeholders.
  • Provides guidance and training to IHM and Medical Affairs staff regarding new and existing statutory, regulatory, legal, accreditation, and other requirements affecting operations.
  • Serves as subject matter expert for commercial lines of business.
  • Responds to inquiries from internal and external auditors, including documentation and audit file preparation.
  • Assists in implementation of audit plans, internal assessments, and other activities to monitor and track compliance involving multiple areas and/or departments in Blue Cross.
  • Represents Compliance in process improvement and policy committees as well as other cross functional committees as needed.
  • Independently lead cross functional meetings as needed.
  • Assist with NCQA standard coordination and documentation.
  • Ad hoc project management and/or other responsibilities as needed by management.

    Required Skills and Experiences:

    • 5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
    • Ability to work collaboratively across departments.
    • Ability to manage work and projects independently.
    • Excellent verbal and written communication and presentation skills, with ability to express complex concepts into simple terms and ability to write clear, concise, and grammatically correct materials.
    • Ability to analyze data. Strong problem-solving and critical thinking skills.
    • Proficient level of Microsoft Office suite required (e.g. Word, Excel, PowerPoint and Access).
    • Recent experience designing and populating databases, which includes download, upload and formatting data.

      Nice to Have:

      • Bachelor's degree.
      • Experience in regulatory, compliance or managed care.
      • Clinical degree or years of experience in working in clinical setting Government, regulatory, or health care compliance combined with experience in managed care-utilization management experience.
      • Demonstrated experience with policy development, formal writing, and reporting.
      • Demonstrated experience with: Conducting audits, Tracking results, Communicating results of audits to stakeholders, Developing action plans based on audit findings.
      • Project management experience.Make A Difference

        Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, gender expression, or any other legally protected characteristic.

        Reasonable Accommodation for Job Seekers with a Disability: If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talent.acquisition@bluecrossmn.com.

        All roles require a high school diploma (or equivalency) and legal authorization to work in the U.S.

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

  • Senior Medical Affairs Compliance Analyst

    1 month ago

    Eagan, Minnesota, United States Blue Cross and Blue Shield of Minnesota Full time

    About Blue CrossBlue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We're committed to reinventing health care to improve health for our members and the community. We hope you'll join us.How Is This Role Important to Our Work?This position is responsible for ensuring that...

  • Senior Cybersecurity Analyst

    2 weeks ago

    Eagan, Minnesota, United States Genesis10 Full time

    Genesis10 is seeking a Senior Cybersecurity Analyst for a contract opportunity.Remote Job Overview:The primary role of a Senior Cybersecurity Analyst involves strategizing, coordinating, and executing security protocols for information systems to manage access to digital data and avert unauthorized alterations, destruction, or exposure of sensitive...

  • Senior IT Business Analyst

    2 weeks ago

    Eagan, Minnesota, United States Genesis10 Full time

    Genesis10 is seeking a Senior IT Business Analyst for a contract opportunity.Remote Job Overview:At Genesis10, we aim to innovate pharmacy management to ensure the same level of care we wish for our loved ones. Within the Medical Pharmacy division, we are presented with numerous chances to modernize outdated systems and enhance business operations through...

  • Senior IT Systems Analyst

    2 weeks ago

    Eagan, Minnesota, United States Genesis10 Full time

    Genesis10 is seeking a Senior IT Systems Analyst - Pega Specialist for a contract opportunity.Remote Job Overview:The Senior IT Systems Analyst will play a pivotal role in bridging the gap between technology and business operations. This position involves leveraging various delivery methodologies to facilitate effective communication between IT and business...

  • Senior Product Analyst

    3 months ago

    Eagan, United States BlueCross BlueShield of Minnesota Full time

    About Blue Cross Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We're committed to reinventing health care to improve health for our members and the community. We hope you'll join us. Blue Cross Blue Shield of MN is hiring a Senior Product Analyst to join our...

  • Senior Financial Analyst

    1 month ago

    Eagan, United States LHH Full time

    Senior Financial Analyst - SalesAre you ready to take the next step in your Finance career? LHH is seeking a Senior Financial Analyst near Eagan, MN that has experience supporting sales in the past or has worked for another CPG or manufacturing organization. This is a hybrid role targeting someone with three or more years of experience, that is career...

  • Senior Financial Analyst

    1 month ago

    Eagan, United States LHH Full time

    Senior Financial Analyst - SalesAre you ready to take the next step in your Finance career? LHH is seeking a Senior Financial Analyst near Eagan, MN that has experience supporting sales in the past or has worked for another CPG or manufacturing organization. This is a hybrid role targeting someone with three or more years of experience, that is career...

  • Senior Business Solutions Analyst

    1 day ago

    Eagan, Minnesota, United States Hollstadt Consulting Full time

    About the RoleHollstadt Consulting is seeking a highly skilled Senior Business Solutions Analyst to join our team. As a key member of our organization, you will play a critical role in driving business growth and improvement through strategic analysis and process optimization.Key ResponsibilitiesBusiness Analysis: Serve as a liaison between stakeholders,...

  • Senior Financial Analyst

    3 weeks ago

    Eagan, United States Marvin Full time

    Senior Financial Analyst ID 2024-4839 Department Accounting Position Type Regular Location US-MN-Eagan Job Overview The Sr. Financial Planning Analyst will partner with business teams to understand operational plans and build financial models that enable better decision making. This role will provide analysis and insight into...

  • Senior Business Analyst

    2 days ago

    Eagan, United States Hollstadt Consulting Full time

    Sr Business AnalystResponsibilities:Serves as a conduit between customers, vendors, and the IT Solutions development team from medium to large sized projects encompassing Medicare Part D and Medicaid.Strong ability to translate existing and non-existing business processes to technical requirements including metadata profiling, understanding SDLC, and the...

  • Senior Commercial Consultant

    1 month ago

    Eagan, Minnesota, United States Thomson Reuters Full time

    This Senior Commercial Consultant is responsible for implementing the special offer contract new/renewal process in support of the LMLF marketing segments. This involves frequent communication with personnel from several functional areas, especially CVM management, Sales and Account Management (SAM), Contracts Counsel (CCM/Legal), Strategic Marketing, SAM...

  • Senior Benefits Consultant

    4 weeks ago

    Eagan, Minnesota, United States Blue Cross and Blue Shield of Minnesota Full time

    About Blue CrossBlue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We're committed to reinventing health care to improve health for our members and the community. We hope you'll join us.How Is This Role Important to Our Work?Blue Cross Blue Shield of MN is hiring a...

  • Senior Benefits Consultant

    4 weeks ago

    Eagan, United States Blue Cross and Blue Shield of Minnesota Full time

    About Blue CrossBlue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We’re committed to reinventing health care to improve health for our members and the community. We hope you'll join us.How Is This Role Important to Our Work?Blue Cross Blue Shield of MN is hiring a...

  • IT Business Analyst III

    1 month ago

    Eagan, Minnesota, United States Genesis10 Full time

    Genesis10 is seeking a IT Business Analyst III for a contract with our client in Eagan, MN. 100% Remote.Job Description:At client, our purpose is to reimagine pharmacy management to provide the same care we want for our loved ones. Within the Medical Pharmacy organization we have many opportunities to modernize legacy platforms and make business processes...

  • Lead Financial Planning Analyst

    2 weeks ago

    Eagan, Minnesota, United States Creative Financial Staffing Full time

    This position is tailored for a client in the manufacturing and agricultural sector, seeking a dedicated professional to oversee Financial Planning and Analysis (FP&A) across various business divisions.The Senior Financial Analyst will be instrumental in driving the FP&A initiatives within the assigned units. Working closely with organizational leadership,...

  • Senior Technical Systems Analyst

    1 month ago

    Eagan, Minnesota, United States Blue Cross and Blue Shield of Minnesota Full time

    About Blue CrossBlue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We're committed to reinventing health care to improve health for our members and the community. We hope you'll join us.How Is This Role Important to Our Work?This position leads, creates and manages...

  • Caregiver - Senior Living Assistant

    2 days ago

    Eagan, Minnesota, United States New Perspective Senior Living Full time

    About the RoleWe are seeking a compassionate and patient Caregiver to join our team at New Perspective Senior Living. As a Caregiver, you will play a vital role in providing daily quality care, engaging activities, and enrichment programs to our residents, assisting them to Live Life on Purpose.ResponsibilitiesCommunicate and interact with residents in a...

  • Employee Relations Partner

    4 weeks ago

    Eagan, United States The Judge Group Full time

    As a Senior Employee Relations Partner, you will leverage your expertise in HR, employment law, and business acumen to uphold our organizational values and foster a positive work environment. Your primary responsibilities include executing the employee relations (ER) strategy, managing complex ER issues, and proactively preventing potential disputes. You...

  • Treasury Analyst

    3 months ago

    Eagan, United States BlueCross BlueShield of Minnesota Full time

    About Blue Cross Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We're committed to reinventing health care to improve health for our members and the community. We hope you'll join us. How Is This Role Important to Our Work? The Treasury Analyst will support all...

  • Lead Business Systems Analyst

    2 weeks ago

    Eagan, Minnesota, United States C4 Technical Services Full time

    Lead Business Systems Analyst at C4 Technical Services Remote OpportunityEssential Qualifications: Minimum of 3 years in a leadership role or higher Up to 2 years for a Senior position or lower Experience collaborating within a team to conduct business and system analysis, quality assurance, and managing project delivery timelines. Ability to work...