Clinical Program Manager

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 Clinical Program Manager provides support to health system provider partners as well as Medica's product and segment teams. The Clinical Program Manager will work collaboratively with leadership and cross-functional partners to design and develop actionable strategies to address health system specific clinical cost and utilization opportunities.

This position is responsible for supporting and maintaining the clinical relationship with Medica's provider partners, working to identify and implement clinical interventions to improve outcomes and quality of care, decrease unnecessary medical spend, and improve care efficiency. The incumbent works in close collaboration with Medica's clinical services, network management, and analytics departments.

This position requires understanding of managed care business practices, provider delivery governance, internal and external operations, design thinking, and the development and use of actionable analytics. Strong relationship management skills are critical for this role as is the ability to manage complex clinical projects using established project management tools and methodologies. Performs other duties as assigned.

Key Accountabilities

Identify and develop clinical interventions and services that positively impact medical trend and quality

• Identify interventions that improve value of care for our members including improved quality and access to appropriate care, while sustaining appropriate decreases in unnecessary medical trends.

Provide insights and recommendations to care system clinical operation teams related to provider clinical operations, with the goal of improving performance in the quadruple aim.

Perform and translate data analysis to highlight care system performance and provide insights into areas of impact and improvement throughout the organization.

Engage providers in strategic collaborative activities

Support Overall Clinical Value Strategy

Required Qualifications

Preferred Qualifications

Skills and Abilities

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, Omaha, NE or St. Louis, MO

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 compensation, 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.

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.