Manager, Medicaid Regulatory Adherence

Description

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.

We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.

The Manager of Medicaid Regulatory Adherence serves as the primary regulatory point of contact for Medicaid / Special Needs programs in North Dakota (ND), Minnesota (MN), and Wisconsin (WI). This position leads a team of Regulatory Adherence Analysts and is responsible for managing relationships with state Medicaid agencies; interpreting and implementing regulatory changes; and ensuring contract and regulatory adherence across the organization. The role also partners closely with Medica's enterprise compliance team to ensure alignment with corporate standards and frameworks. Performs other duties as assigned.

Key Accountabilities

Regulatory and State Engagement

• Serve as the primary Medicaid regulatory liaison with state agencies in ND, MN, and WI
• Develop and lead annual contract assessment reviews of existing and new contract requirements
• Lead state Medicaid contract negotiations, renewal, and amendment process
• Monitor trends of State Medicaid agency inquiries and issues, communicate internally, implement corrective action as needed
• Monitor and analyze Medicaid and Special Needs Plan regulatory changes, guidance, and legislation, and translate those changes into actionable requirements for internal teams
• Identify and communicate any known regulatory risks to Medicaid leadership team.

Team Leadership and Oversight

Compliance Collaboration

External Partnerships

Required Qualifications

Strongly Preferred Qualifications

This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations : Minnetonka, MN, or Madison, WI.

The full salary grade for this position is $87,100 - $149,300. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $87,100 - $130,620. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and / or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

Eligibility to work in the US : Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities

This employer is required to notify all applicants of their rights pursuant to federal employment laws.

For further information, please review the Know Your Rights notice from the Department of Labor.