Director Compliance Operations

Blue Cross Blue Shield of Minnesota is hiring a Director Compliance Operations in Eagan, MN. The Director of Compliance Operations leads the design, execution, and continuous improvement of the enterprise compliance program. This role ensures adherence to federal and state regulations, industry standards, and internal policies while fostering a culture of integrity and ethical conduct.

The Director is a strategic advisor and deep subject matter expert across Medicare, Medicaid, and Commercial health insurance. This role oversees the Code of Conduct, regulatory change management, corporate policy governance, vendor risk management, regulatory reporting, licensing, and regulatory attestations, and all aspects of compliance program effectiveness. The position carries enterprise-wide responsibility and drives compliance program maturity through metrics, dashboards, and disciplined operational excellence.

Key Responsibilities

• Ensure enterprise-wide compliance with all regulatory requirements, internal policies, and ethical standards across all business lines.
• Serve as a subject matter expert in Medicare, Medicaid, and Commercial regulations, advising executives and operational leaders.
• Develop and maintain key relationships with relevant regulators, including serving as the Medicare and Medicaid Compliance Officer.
• Direct the Corporate Policy Office, including policy development, review, approval, and annual Code of Conduct updates.
• Lead regulatory change management, including analysis, ownership assignment, and timely implementation of new requirements.
• Oversee integration of compliance controls into vendor agreements and contracting processes, pre-delegation reviews, and ensure audit readiness.
• Direct the conflict-of-interest disclosure process, exclusion screenings, and mandatory compliance training in partnership with HR.
• Develop and maintain centralized compliance metrics, dashboards with Key Risk Indicators (KRIs), and regulatory reporting for oversight bodies.
• Oversee organizational licensing, regulatory attestations, certifications, and timely regulatory filings.
• Lead the compliance hotline reporting and investigation functions.
• Lead, develop, and mentor a high-performing compliance team.

Qualifications

• Minimum 7 years of related and progressive experience in compliance, regulatory affairs, risk management, or legal roles within healthcare, insurance, or other highly regulated industries.
• At least 5 years in a leadership or people management role.
• Experience in healthcare compliance, managed care, or insurance environments.
• Deep knowledge of federal, state, and industry regulations (HIPAA, CMS, state Medicaid requirements).
• Demonstrated experience with Medicare, Medicaid, and Commercial programs.
• Strong analytical, organizational, and problem-solving skills.
• Exceptional written and oral communication skills.
• Proficiency with compliance platforms, reporting dashboards, and modern workplace tools utilizing AI.
• High school diploma (or equivalency) and legal authorization to work in the U.S.

Preferred

• Bachelor's degree or higher in business, healthcare administration, public health, law, or related field.
• Professional certifications such as Certified in Healthcare Compliance (CHC) or Certified Compliance & Ethics Professional (CCEP).
• Experience creating materials and presenting to boards, compliance committees, or regulatory bodies.

Compensation

$135,500 - $182,900 - $230,300 Annually. Comprehensive benefits including medical, dental, vision, life insurance, 401k, and PTO.

Role Designation: Hybrid (two days per week in office)