- Company: Blue Cross and Blue Shield of Minnesota
- Location / Remote: Remote (preference for Minnesota residents)
- Employment Type: Full-time
- Region / Market: United States (Healthcare Insurance & Provider Network Operations)
- Seniority Level: Senior Specialist / Lead
- Department / Function: Provider Data Integrity & Network Operations
Company Overview
Blue Cross Blue Shield Association member organization focused on improving healthcare access, regulatory compliance, and provider network transparency through accurate and reliable healthcare information.
Role Purpose
This role ensures the accuracy, integrity, and regulatory compliance of provider demographic data used in provider directories. It maintains provider relationships, manages complex data updates, leads process improvements, and trains specialists to ensure operational excellence.
Key Responsibilities
Provider Data Integrity & Compliance
- Maintain accuracy of provider demographic data
- Ensure compliance with regulatory and business requirements
- Update multifaceted systems using verified provider data
Provider Communication & Relationship Management
- Maintain timely communication with assigned providers
- Work directly with providers via phone, electronic channels, and in person
- Share quarterly demographic reports with complex provider groups
Process Leadership & Training
- Lead and direct work of outreach specialists
- Develop and implement processes and procedures
- Train associates and support operational improvements
Issue Resolution & Escalation Management
- Resolve complex and escalated provider data issues
- Manage documentation and provider records
- Ensure timely completion of forms and workflows
Data Analysis & Reporting
- Analyze trends and provider data patterns
- Review findings with management
- Generate and share provider-specific reports
Cross-Functional Collaboration
- Lead internal and external workgroups
- Build relationships across departments and stakeholders
- Support customer and provider satisfaction initiatives
Required Skills & Experience
Must-Have
- 3+ years relevant professional experience
- Experience writing procedures & training staff
- Advanced Microsoft Office skills (especially Excel)
- Strong communication & relationship-building skills
- High accuracy, critical thinking, and attention to detail
Nice-to-Have
- Bachelor’s degree
- Healthcare operations or call center experience
- Document management experience
- Training and operational support experience
- Experience working remotely
Tools, Tech & Methodologies
- Provider demographic data systems
- Microsoft Excel & Office Suite
- Document & workflow management systems
- Data reporting & compliance tracking tools
Success Metrics / KPIs
- Accuracy of provider directory data
- Regulatory compliance & audit readiness
- Provider satisfaction & responsiveness
- Resolution time for escalated issues
- Process improvement effectiveness
- Training effectiveness & team productivity
Who This Role Is Best For
This role is ideal for professionals experienced in healthcare operations, provider network management, or data integrity roles who enjoy improving processes, maintaining compliance accuracy, and working directly with providers to ensure reliable healthcare information.
Compensation & Benefits
Salary Range: $60,000 – $85,000 annually
Benefits may include:
- Medical, dental & vision insurance
- Life insurance
- 401(k)
- Paid Time Off & Volunteer PTO
- Comprehensive benefits package
Travel & Location Requirements
- Remote role (preference for Minnesota residents)
- Occasional provider-facing interaction (virtual or in-person)
Notable Signals (Recruiter / ATS Insights)
✅ Leadership responsibilities (training & process development)
✅ Strong regulatory & data accuracy focus
✅ Provider relationship management is critical
✅ Healthcare operations & compliance knowledge valued
✅ Excel & reporting proficiency important