Manager, Accreditation Manager

About the Role

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. As a Blue Cross associate, you are joining a culture built on values of succeeding together, finding a better way, and doing the right thing.

This role leads and oversees accreditation program activities that support organizational compliance, quality performance, and survey readiness across multiple lines of business. The Manager, Accreditation Manager is responsible for planning and executing complex accreditation initiatives, ensuring ongoing compliance with NCQA standards, and successfully guiding the organization through the full accreditation lifecycle, including survey preparation, documentation management, evidence collection, file review coordination, and survey submission.

Working closely with cross-functional leaders and business owners, this role interprets accreditation requirements, provides training and consultative guidance on standard implementation, and helps develop processes, policies, and procedures that align with accreditation expectations. The position manages accreditation-related risks, monitors compliance activities, coordinates readiness assessments, and oversees documentation and reporting to support successful survey outcomes.

Responsibilities

• Collaborate with leadership to design and implement practices, processes, and tools that support accreditation strategy, compliance, and readiness.
• Plan, direct, and coordinate projects associated with the department’s accreditation strategy.
• Develop enterprise reporting and coordinate documentation of accreditation compliance to support oversight, reporting, and formal accreditation survey submissions.
• Manage an accreditation team, with accountability for the full associate lifecycle, including workforce decisions, performance and talent management, employee relations, policy compliance, and cost control.
• Leverage organizational knowledge and business acumen to develop effective cross-functional teams and lead through influence to successfully complete projects.
• Identify accreditation compliance issues and risks and escalate both concerns and potential solutions appropriately.
• Maintain appropriate project documentation to support accreditation oversight, reporting, and readiness.
• Communicate, consult, and support implementation of accreditation requirements to ensure compliance issues are addressed and projects are completed according to established guidelines.
• Research and stay current on accreditation-related emerging business and technology trends/issues/topics within the healthcare industry, the Blues System, and the Minnesota market.
• Perform additional responsibilities consistent with the scope and level of the role, as assigned.

Requirements

• 5+ years of progressive medical care management experience, with 1+ years of staff, team lead, or project lead 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 Qualifications

• Master’s degree in a related field.
• Healthcare experience and/or knowledge of the managed care and health care/insurance industry.
• Experience with accreditation and/or compliance regulations for clinical programs.
• Experience managing complex/multiple projects simultaneously.
• Process improvement and ability to implement tools or systems that improve team efficiency and accuracy.
• Demonstrated experience with policy development, formal writing, and reporting.
• Ability to build and maintain relationships with internal and external stakeholders, clinicians, and others.
• Strong documentation and workflow process skills.
• Knowledge of medical terminology and procedures.
• Understanding of medical claims and coding.
• Ability to communicate expectations and priorities clearly to team members, actively listen to resolve issues and remove barriers, and drive alignment across teams and stakeholders.
• Ability to analyze department challenges, guide team decision-making, and collaborate across teams to drive resolution and next steps.
• Ability to effectively organize team work, balance priorities across projects, and manage time and resources to ensure timely delivery and coordination.

Schedule

Hybrid approach: two days in the office each week, with at least one anchor day designated for team interaction. The rest of the week is remote.

Pay

Pay Range: $102,400.00 - $138,300.00 - $174,200.00 annually. Pay is based on several factors, including skills, ability, and knowledge.

Benefits

• Medical, dental, and vision insurance.
• Life insurance.
• 401k.
• Paid Time Off (PTO).
• Volunteer Paid Time Off (VPTO).