Medica jobs in Madison, WI

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. Utilize comprehensive knowledge of the Healthcare Industry, business processes, and IT systems to resolve issues, automate and improve business processes, and assist with the implementation of IT solutions. Key Accountabilities * Requirements Analysis * Produce artifacts that may include feature definitions, User Stories, flow-charts, swim-lanes, SIPOCS, source to target documents and feasibility studies. * Work with business stakeholders and partners to help identify and understand their requirements within the scope of a project * Gain alignment by asking effective questions, gathering the right individuals for elicitation, conducting productive facilitation, negotiating compromises and establishing relationships * Generate user stories and/or deep functional and technical requirements that are sufficient to capture the essence of what is being asked, why it is important and who benefits from the effort * Ensure that requirements clarify the business value and are accessible and understandable to any team member or stake holders * Engage with the product team towards defining a solution that addresses the requirements in a way that will be satisfying to our stakeholders * Assist with data analysis in support of issue resolution or solution options on highly complex projects * Feature Delivery * Working with the Scrum Master to provide updates for keeping the team and business stakeholders on track for meeting commitments. * Drive decision making, compromise and agreement by identifying deliverables that provide value. * Clarify the approach for gathering requirements and managing issues and risks. * Work with technical teams to identify solution options that best meet business need. * Communication * A primary skill-set of a BA (any level) is appropriate, timely and polished communication * The Sr. BA is responsible for escalation when required, resolving conflict if needed, gaining formal approval of business requirements, and working with business segment leads, operations team members and IT team members for successful implementation * Consultation and BA Practice Support * The BA will explore ideas, assess current business processes to identify improvement opportunities (technical and operational), conduct gap analysis, and help to develop business cases * Partner with the technical team to outline solutions and provide estimates and identify risks * Support creation of test plans / scenarios, post-implementation support requirements, and lessons-learned * Use industry defined techniques and best practices to aid in all BA accountabilities including elicitation and definition of requirements * Assist peers to continue to define and develop practice improvements and apply them to the delivery process * Provide guidance and support to junior BA's Required Qualifications * Bachelor's degree or equivalent experience in related field * 7 years of work experience beyond degree Preferred Qualifications * 5-8 years minimum experience in Data Management, Data Integration, ETL development with considerable experience with Informatica ETL * Master's Degree This position is an Office role, which requires an employee to work onsite at our Minnetonka, MN office, on average, 3 days per week. 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. 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.

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. Responsible for the implementation and maintenance of Medica's Epic Payer Platform Health system. Supports internal business owners and coordinates with IT partners for downstream capabilities. Supports platform configuration and maintenance supporting business unit service levels. Ensure system updates and changes are delivered and tested as expected and on time. Responsible for managing highly visible Epic projects that cross multiple business and IT areas. This role must partner with IT and other stakeholders to ensure the right blend of skills are available to support successful delivery of the Epic Program. Performs other duties as assigned. Key Accountabilities * Supports and maintains Medica's Epic Payer Platform * Provides direction to other staff and performs more advanced responsibilities with minimal supervision. * Providers leadership and consultation to internal Medica teams * Ensure strong Epic program governance which includes proactive risk and issue management and reporting * Responsible for tracking and measurement of internal program success Required Qualifications * Bachelor's degree or equivalent experience in related field * 7 years of experience beyond degree Skills and Abilities * Epic Payer Platform technical experience, Clarity, Caboodle, Data Courier, etc * Bachelor's degree or equivalent experience in related field * Knowledge of health care functions between payers and providers, quality, risk adjustment, or care management * Advanced working knowledge of Epic, preferably from the payer perspective * EPP work experience desired 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, Madison, WI, 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. 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.

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 Supervisor, Case Management, is accountable for the day-to-day operational support and strategic activities of the assigned team. This position is also accountable for achieving department objectives and maintaining flexibility to meet business needs. Responsibilities include supervision of the clinical and non-clinical team members, ensuring that the strategic and business processes are established, maintained and communicated, and effective interdepartmental communications are established. This position resides in the Health Management department yet interacts regularly with other areas within Medica. In addition to the coaching and staff development responsibilities, the Case Management Supervisor must also build strong relationships with internal and external partners. More specifically, support the Manager, Case Management in relationship building within Medica and its vendor partners to help prioritize, integrate and coordinate interventions for population segments based on medical, behavioral and social needs. The supervisor will support the manager and work with staff to integrate and understand accreditation requirements and incorporate them into program activities. Supervisory responsibilities include: * Supervise day-to-day team responsibilities: recruiting, hiring, training and team members. Audit team members for compliance against policies and procedures and NCQA audit requirements. Manage team members' workload and monitor staffing ratios. Provide performance appraisals and reward recognition. * Ensure that the Case Managers are accountable for engaging the members. * Facilitate assigned team meetings and work with Managers and Supervisors and leads for coordinated departmental team meetings, functions and responsibilities. Provides support to Manager to run monthly reports for business segments and leadership on key performance targets including, engagement of members, productivity, closure of gaps in care, outcomes, satisfaction surveys and quality indicators. Key Accountabilities: * Supervise and Maintain Efficient Department Operational Systems/Process * Comply with policy and procedures effectively and with appropriate documentation and ensure team meets all department, regulatory and accreditation requirements and goals * Informs the Manager of process, procedure, policy and other issues that cannot be resolved within the team * Model change management philosophies and support and facilitate a positive approach to change among team members * Monitor team members' calls and casework to ensure staff is following department guidelines, processes and turn-around times * Manage performance and hold staff accountable for meeting department standards for quality, turn around times, policy application, effectiveness, attendance, and personnel management, etc. Formulate action plan for less than acceptable performance * Consult human resources and manager to ensure compliance with company policies and values * Responsible for personnel management including interview process, goals establishment, performance review, and team-building * Assist with delivery of new employee orientation programs for team members, and contributes to the development, maintenance and communication of educational programs as indicated * Compile and report team and individual statistics for planning and evaluation * Assist the Manager to define and utilize performance standard to monitor staff performance * Accountable for driving performance toward goals and communicating effectively to peers when process gaps are impeding goals * Manage Performance of Multi-focused Team * Leads and supervises the program and team as outlined under the Position Overview section * Ensures that the team successfully meets and exceeds process-oriented outcomes * Assess the training and development needs of each new employee to result in fully competent performance within one year. Assess existing employees for training and development needs or performance improvement plans * Provide team members with ongoing and consistent feedback, directed toward clinical excellence and accountability to department goals * Regularly assess and measure team workload and staffing ratios, ensure workload is evenly distributed. Develop and implement plan for backlog situations when needed. Communicate workload and turn-around times * Coach, encourage and facilitate individual growth and development through specific, timely and consistent feedback. Conduct regular and timely one on one meeting * Ensure timeliness and accuracy of all required administrative functions, i.e. timecards, performance evaluations, call recordings, expense reports, etc., * Communicate management decisions in a positive manner to staff * Accessible during workday to facilitate problem solving and resolution of case review issues and complaints * Take phone calls, handle escalated issues and provide setting for clinical case consultations * Provide technical and clinical support to staff by researching and responding to their questions * Coach staff on the Quality Audit results. Recommendations from audits are evaluated and appropriate improvement measures are taken * Project and Group Management and Industry Knowledge * Work closely with project management team on implementation of new and renewing clients and for new and ongoing company and department initiatives * Exhibit skills in organization, project management, time management and meeting facilitation * Assist in the development, implementation or maintenance of department programs, which reflect quality of service and care as delegated by the manager * Represent Care Management at interdepartmental meetings and committees * Establish and Maintain Positive Relationships with Internal and External Customers * Assist in developing and maintaining strong, positive and open relationships with the employer groups and other internal and external stakeholders * Listen to and understand customers' questions, concerns or problems Required Qualifications: * Bachelor's degree or equivalent experience in related field * 5 years of work experience beyond degree * Registered Nurse with current licensure in the State of Minnesota or Wisconsin Licensure/Certifications: * RN License * Certified Case Manager (CCM) preferred or the ability to obtain within two years Preferred Qualifications: * Experience in a healthcare setting * Understanding of Medicare/Medicaid Programs from Minnesota/Wisconsin * Three to five years' experience and expertise in communicating with staff in different positions and all levels of management positions * Excellent customer service skills and proven team building skills * Excellent computer skills including Microsoft Word, Outlook, Power Point and Excel * High degree of initiative and ability to work independently, and within a group * Demonstrated effective project management skills, including use of project planning and tracking tools; development of achievable goals, objectives, and timelines; and innovative use of resources * Ability to plan, organize and prioritize work effectively, including the flexibility to accommodate frequent changes * Strong problem solving skills * Knowledge of NCQA, Motivational Interviewing, Evidence Based Medicine and coaching * Consultant skills to articulate business needs and translate to quality programs that result in targeted staff competencies. * Strong leadership skills 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, and Madison, WI. The full salary grade for this position is $77,100 - $132,200. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $77,100 - $115,710. 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 are 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.

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. Medica's Senior Account Executive is responsible for managing and nurturing client relationships, driving customer strategy, and overseeing the renewal process. This role involves collaborating with internal teams to determine appropriate pricing strategies, providing valuable insights on product and service improvements, and ensuring a seamless client experience. The ideal candidate will be strategic, proactive, and focused on delivering value to both clients and the company. Performs other duties as assigned. Key Accountabilities Retention & Renewals Management Own the end-to-end renewal process for assigned commercial accounts Develop and implement strategies to maximize retention Ensure timely and smooth contract renewals for clients Client Relationship Management & Customer Strategy Partner with the account manager to be the primary point of contact for assigned accounts Build strong, long-term relationships and establish trust with clients Proactively identify client needs and provide strategic recommendations to improve their experience and drive business success Upselling & Revenue Growth Identify and pursue upselling and expansion opportunities within existing accounts Collaborate with internal teams to present value-driven proposals to clients Negotiate pricing and contract terms to drive additional revenue growth Cross-Functional Collaboration & Process Improvement Partner with Account Managers and the Commercial Center of Excellence to enhance the client experience Provide insights on pricing, product, and service improvements based on client feedback Contribute to internal strategies aimed at improving retention and revenue outcomes Required Qualifications Bachelor's degree (Preferred in Business, Marketing, Finance, or related field) or equivalent experience in related field 5+ years of related work experience beyond degree Preferred Qualifications Proven experience in account management, sales, or customer success, preferably in a commercial or business to business environment. Experience focused in the areas of sales and retention within the health insurance industry strongly preferred Previous experience building relationships with Brokers and group administrators preferred Demonstrated experience in financial aspects of account management, including benefits rate analysis and cost modeling Proven track record of building and sustaining strategic relationships with clients, brokers, and internal partners to drive mutual success Wisconsin Accident/Health License or the ability to obtain within the first 90 days of employment Skills and Abilities Ability to communicate externally (Brokers, group administrators, etc.) Strong interpersonal skills (listening, mentoring, motivating) Collaborate and partner cross-functionally (Operations, Leadership, Account Executive, Sales Relationship Manager, etc.) Insurance or Healthcare industry knowledge and demonstrated proficiency in working with health plans Exceed client and broker partner expectations through proactive communication and best-in-class service Enhance department and organization's reputation by accepting ownership for accomplishing new and different requests, exploring opportunities to add value to job accomplishments Responsible for collaborating with the Sales team to successfully on-board and integrate new clients Serve as liaison for clients and internal stakeholders This position is an Office role, which requires an employee to work onsite at our Madison, WI office, on average, 3 days per week. The full salary grade for this position is $81,000-$139,300. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $81,200 - $121,800. 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.

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. This Program Manager will oversee initiatives within Medica's Clinical Services Optimization division, with a primary focus on the electronic prior authorization (ePA) business delivery. The Program Manager is accountable for leading program planning, gathering and documenting business requirements, ensuring seamless daily operations of ePA, and driving process improvements. This role coordinates and guides cross-functional teams-including network, Technology, and claims operations-from concept and requirements through delivery, ongoing maintenance, and validation. The Program Manager is responsible for operationalizing regulatory and business requirements to support both compliance and strategic growth initiatives. Serving as the ePA clinical documentation system subject matter expert, this leader acts as the primary liaison among Clinical Services, other business units, Medica IT, clinical platform vendors, and reporting teams, ensuring alignment of program objectives and successful implementation of solutions. Performs other duties as assigned. Key Accountabilities * Program Manager for ePA delivery * Lead Delivery and Optimization of ePA Workflow * Drive process efficiency and oversee the management of error handling within the electronic prior authorization (ePA) workflow * Lead business validation activities and user acceptance testing (UAT) to ensure that system solutions meet organizational needs and requirements * Assess and ensure that all systems and procedures are operating as designed, maintaining high standards for operational reliability and effectiveness * Evaluate requests for changes to the system, determining feasibility and implications for business operations * Develop actionable recommendations to address business system and reporting issues, ensuring continuous improvement and alignment with program objectives * Implement automation and standardized practices to reduce manual processes, eliminate duplication, and enhance overall operational efficiency * Expert Oversight of Clinical Documentation System as it relates to cross functional ePA delivery * Research system functionality and provide subject matter expertise to business and project teams, supporting informed decision-making and effective system utilization * Support process improvement initiatives by collaborating with stakeholders to identify opportunities for enhancement and innovation * Guide recommendations and facilitate decision-making through active stakeholder engagement, ensuring that program goals and stakeholder interests are aligned * Interpret customer needs and translate them into clear application and operational requirements, serving as a bridge between end users and technical teams * Cross functional Collaboration * Work cross functional with business partner to achieve program delivery * Create strong partner relationship to be successful * Drive Clinical and Health Service business readiness by leading for success strategies Required Qualifications * Bachelor's degree or equivalent experience in related field * 8 years of related work experience beyond degree Skills and Abilities * Implementation and new capabilities delivery experience * Computer proficiencies including Microsoft Office (Word, Excel, Access, Outlook, Visio, Onenote, Teams, etc.) and experience with other * Program functions (workflow, eligibility, claims, etc.) * Ability to lead and be a good role model, influence change, shape and initiate work with colleagues across the organization and external (care systems, community collaborations, and vendors) to achieve department goals * Ability to provide leadership based on teamwork, commitment & creative linkages with organizational business units, external vendors and care system representatives * Excellent written and verbal communication skills with all levels of the organization * Knowledge of computer applications, such as Microsoft Office, Microsoft Project and Vision, Access, and familiarity with using database systems * Managing/Delegating/Measuring Work: Ability to develop and assign clear, appropriate objectives, accountabilities and measures working within cross functional workstreams. Ability to monitor and report progress; identify and address barriers * Quality Focus: Commitment to continuous quality improvement in all aspects of work. Skilled user of quality tools and techniques * Experience setting expectation and direction for program delivery 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 $98,400 - $168,600. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $98,400 - $147,525. 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. 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.

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 Reimbursement and Incentives Analyst II analyzes provider reimbursement and incentive program methodologies and strategy to identify opportunities for network intervention and potential areas to reduce cost. Models and forecasts changes in reimbursement rates and methodologies and their associated financial impact to organization and assists with development of cost estimates and budget development/monitoring. Assists with communication to physicians, providers, and facilities regarding various reimbursement and incentive programs. Performs other duties as assigned. Key Accountabilities Documenting processes, dependencies, and tools to maintain fee schedules in Medica's provider reimbursement payment platforms. Support provider contract modeling solutions and contract modeling Work together with key stakeholders to optimize Medica's provider negotiation model process through the promotion of refinements to improve model functionality, efficiency, and accuracy. Promotes and participates in efforts focused on data stewardship and best practices Provide support to expansion growth on the Medicare/Medicaid initiatives as a subject matter expert. This may include locality based payments, regulatory pricing and reimbursement changes, and development of fee schedules from CMS resources Interacts heavily with team members and other departments. Builds strong relationships with groups across the organization, including: Network Management, Provider Network Operations, and IT Provides support to network management strategic initiatives Required Qualifications Bachelor's degree or equivalent experience in related field 3+ years of work experience beyond degree Preferred Qualifications Experience working in Healthcare OR Healthcare Payer preferred Preferred SQL and SAS experience but not required Knowledge with Ancillary reimbursement including: Home Health Care, Durable Medical Equipment, Home Infusion Therapy, etc. Healthcare reimbursement and fee schedule development and implementation including uploading new fee schedules, tracking fee schedule activity, and facilitating fee schedule provider renewal impacts and coding updates preferred This position is an Office role, which requires an employee to work onsite at our Madison, WI office, on average, 3 days per week. The full salary grade for this position is $55,400 - $95,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $55,400 - $83,160. 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. 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.

Our Claims department is currently seeking Senior Outside Property Adjusters for the Wisconsin territory of Madison. This is a remote full-time/exempt role with field investigations. Outside property adjusters handle property claims requiring field investigations and/or inspections. They must establish rapport with our insureds and maintain relationships with our agents, underwriters, contractors, restoration vendors, and experts. They are expected to know their territory, including the geography; regulations and the law as pertains to property claims; state and local public safety and regulatory agencies and officials; the insurance and legal climate; and public adjusters. Outside property adjusters may use a company claims office location as their base of operations, or they may work out of their homes. IN THIS ROLE, YOU WILL: Handle personal property claims requiring outside field investigations and/or inspections May use a company claims office location as their base operations, or they may work out of their homes Handle business interruption (BI) features in conjunction with BI specialists Work within specific limits and authority on assignments of moderate technical complexity Possess functional knowledge and skills reflective of fully competent practitioner Identify possibly suspicious claims Investigate, analyze, evaluate and negotiate personal claims of minimal to moderate complexity May handle low complexity commercial claims May be responsible for all aspects of each claim, including informal hearings, arbitrations, and claims litigation and maintaining a high level of productivity, confidentiality and customer service Implement and coordinate the most effective management techniques to mitigate loss and expense payments Settlement and reserving authority levels are moderate Required to have and maintain sufficient home-based internet connection WHAT YOU NEED TO APPLY: 2+ years of experience adjusting claims Preferred experience with Xactimate estimating software Must have or secure and maintain appropriate states adjuster license(s) and continuing education credits Must have valid driver's license Dedicated to meeting the expectations and requirements of internal and external customers Makes decisions in an informed, confident and timely manner Maintains constructive working relationships despite differing perspectives Strong organizational and time management skills Ability to negotiate skillfully in difficult situations with both internal and external groups Demonstrates ability to win concessions without damaging relationships Demonstrates strong written and verbal communication skills Promotes and facilitates free and open communication Understanding of applicable statutes, regulations and case law Think critically and anticipate, recognize, identify and develop solutions to problems in a timely manner Easily adapt to new or different changing situations, requirements or priorities Cultivate an environment of teamwork and collaboration Operate with latitude for un-reviewed action or decision Computer experience (MS Office, excel, word, etc) Proficient using Claims systems (i.e. CSS, PMS, etc.) Ability to use a personal computer and other standard office equipment Ability to travel as necessary Ability to sit and/or stand for extended periods Ability to operate a motor vehicle 4-5 hours per day and to get in and out of the vehicle numerous times during the day Ability to load and unload equipment and supplies weighing up to 30 pounds from a motor vehicle as needed to perform field work Ability to bend, walk, and climb for several consecutive hours while inspecting damaged buildings, often with utilities turned off or inoperable Ability to use a ladder safely to get onto and off of roofs, and maintain balance while inspecting roofs Ability to perform field work in adverse weather This job posting provides cursory examples of some of the job duties associated with this position. The examples provided are not complete, and the position may entail other essential and job-related functions and responsibilities that employees will be required to perform.

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. Analyze and evaluate the likelihood of future events in order to reduce and manage future risks. Complete and interpret actuarial analysis, valuations, cost estimates, and modeling using statistical programming and database tools. Perform rate level pricing functions and prepare monitoring reports on program or product pricing. Measure historical relationships to develop forecasts and identify trends. Performs other duties as assigned. Required Qualifications * Bachelor's degree or equivalent experience in a related field. * Minimum of 5 years of work experience beyond degree. * Associate of the Society of Actuaries (ASA) designation. Preferred Qualifications * Experience in healthcare or insurance actuarial work. * Knowledge of reserving and monthly financial reporting. * Advanced proficiency in statistical programming and database tools. 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, Madison, WI, 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.

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. Responsible for developing, implementing and managing a portfolio of Medicare Advantage products. Develops and manages competitive offerings by overseeing market research and regulatory requirements. Defines and implements product features with a member experience focus. Assists with managing and analyzing product performance. May have interaction with regulatory bodies. Performs other duties as assigned. Key Accountabilities * Maintains source of truth documents for Medicare Advantage (MA) plans which is crucial to maintain alignment between four areas: Product pricing, CMS bid submission, system configuration and legal/required member documents. * Completes plan benefit package (PBP) software responses for annual CMS bid submission through its Health Plan Management System (HPMS) and has thorough understanding of the PBP category definitions. * Bid subject matter expert (SME) and leader of the Bid Best Practices group to align the organization's bid submissions across product lines and support other bid submitters. * Conducts deep competitor analysis, collects competitor materials and assembles competitive reports and analyses. * Supports 1/1 readiness and vendor management activities. * Resource to the enterprise to answer product intent questions for internal stakeholders such as Sales, Customer Services, Pharmacy and Configuration; MA product representative on internal workgroups such as Government Program Issues Tracker, Regulatory Change, Enrollment/Application, Provider Term and other workgroups. * Assists with managing and analyzing product performance by reviewing reports and works to identify trend drivers and possible solutions in coordination with enterprise efforts. Required Qualifications * Bachelor's degree or equivalent experience in related field * 7 years of related work experience beyond degree Preferred Qualifications * Experience working with Medicare Advantage plans, the CMS bid cycle, and CMS's Health Plan Management System (HPMS) software * Experience in conducting of market research, competitive analysis, and the development of business cases * Experience in the analysis, summary, and presentation of business reports to organizational leaders and regulatory officials * Excellent organizational skills with proven ability to manage projects from kick-off to implementation * Excellent interpersonal communication skills with proven ability to establish and maintain strong relationships at multiple levels of an organization * Ability to quickly adapt to change and work independently * Proficient in Microsoft Excel, PowerPoint, and Word 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: Minneapolis, MN, Madison, WI, Omaha, NE, 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 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. 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.

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. Medica's Legal and Regulatory Analyst works as part of our legal team to support Medica's various lines of business. This role will primarily support the Individual and Family business on and off state and federal marketplaces but will also support other LOBs. This role will provide support for the various LOBs by gathering information; researching state and federal law and regulations; drafting memos, contracts and other legal documents; drafting generic as well as state specific language for inclusion in policy documents. Submit, track, monitor and successfully complete state and federal filings submitted to obtain licenses, certifications and product approval. Performs other duties as assigned. Required Qualifications Bachelor's degree or equivalent experience in related field 7 years of work experience beyond degree Preferred Qualifications 7+ years of work experience beyond degree in the insurance field, preferably health insurance, or other highly regulated industry Experience with regulatory filings, at the state and federal level, including SERFF and HIOSS Knowledge of the Affordable Care Act and ERISA issues Healthcare/insurance experience or experience in another highly regulated industry Experience in compliance area, including reviewing laws and drafting summaries Juris Doctor preferred but not required Skills and Abilities Strong legal research and analytical skills Attention to detail with strong organizational skills Microsoft Office proficiency; knowledge of Excel helpful Ability to develop and manage project plans across various business units Strong written and verbal communication skills Motivated and self-starter; ability to work independently and adapt to change quickly Demonstrated interpersonal skills; ability to build credibility and rapport with internal and external stakeholders, including state or federal regulators 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. 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.

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 Healthcare Analyst III serves as a strategic analytics partner supporting Medica's Lines of Business (LOB), including Medicare, Medicaid, Individual and Family Business (IFB), and Commercial. This role is responsible for leading the development and delivery of analytics across all LOBs-providing insights, reporting, and strategic recommendations to drive business performance. The ideal candidate combines strong analytics acumen with consultative and communication skills to influence decision-making across diverse business units. Performs other duties as assigned. Key Accountabilities Act as a subject matter expert on healthcare analytics, providing advanced guidance on the interpretation and application of complex medical and pharmacy data Lead the development of analytic frameworks that support client strategies, affordability initiatives, and operational performance improvement Collaborate with internal stakeholders to translate business questions into analytic approaches aligned with strategic goals Proactively identify emerging trends and opportunities through data exploration and advise leadership on implications and recommended actions Serve as a key liaison between analytics and business teams, ensuring that insights are actionable, relevant, and integrated into decision-making processes Translate complex data into clear, actionable insights and recommendations for business stakeholders Ensure data integrity and consistency across reporting and analytic outputs Respond to ad hoc analysis requests with timely, accurate, and insightful deliverables Support internal teams with data interpretation, metric development, and performance tracking Collaborate with cross-functional teams across the broader business Present findings to executive leaders, tailoring insights to strategic priorities Employ best practices in storytelling and visualization to drive engagement and understanding Design and implement benchmarking studies that inform strategic initiatives Required Qualifications Bachelor's degree or equivalent experience in related field 5 years of work experience beyond degree Preferred Qualifications Advanced working knowledge of healthcare analytics, affordability metrics, and medical/pharmacy data trends Proficiency in SQL, data visualization tools (e.g., Tableau, Power BI), and statistical methods Strong proficiency in data analysis tools (e.g., SAS, SQL, Python, R) and Microsoft Office applications Demonstrated ability to extract, evaluate, and interpret complex data sets with strong analytical and problem-solving skills Excellent written and verbal communication skills, capable of conveying complex information clearly and concisely to diverse audiences Experience working both independently and collaboratively in cross-functional teams Ability to function as a subject matter expert and mentor to other staff 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 $77,100 - $132,200. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $77,100 - $115,710. 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. 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.

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 Senior Complex Contract Manager role will be accountable to partner with internal Medica teams to negotiate complex and/or cross-functional contracts with Medica vendors. The Senior Complex Contract Manager will be responsible for running negotiations for designated business areas and partnering with the Sourcing and Category Management and Vendor Management teams to ensure contract terms meet business needs, price and performance requirements, and compliance with all applicable laws and regulations. The Senior Complex Contract Manager will lead strategy for negotiations that will include pricing, Medica-preferred terms and conditions, risk mitigation, and best-in-class service level performance agreements/guarantees. This role will work cross-functionally with Legal, Technology, Finance, and Operations to ensure deviations from Medica-preferred terms and conditions are properly considered in the context of the vendor's services. Performs other duties as assigned. Key Accountabilities * Strategic Negotiation * Exercise independent judgment when analyzing information and evaluating results to lead Medica business teams to the best negotiation strategy for the situation * Develop and negotiate complex contracts for products and services that include pricing, Medica-preferred terms and conditions, risk mitigation, and best-in-class service level performance agreements/guarantees * Navigate high-pressure situations to resolve conflicts effectively * Maintain appropriate attention to detail while managing multiple complex negotiations at the same time * Collaborate and creatively solution with Medica attorneys when needed to ensure contract terms comply with legal and regulatory requirements * Analyze contract terms to identify opportunities for improvement * Business Relationship Management * Utilize effective communication and collaboration skills to establish strong relationships with business partners to align on the strategic and tactical direction for vendor negotiations * Collaborate with multiple stakeholders and vendors to negotiate favorable contract terms and maintain positive working relationships * Effectively communicate business critical information including complex contract terms, in a clear and concise manner, to both internal stakeholders and external partners * Contract Management * Ensure contracts and relevant contract data are entered into Medica's contract management tool Required Qualifications * Bachelor's degree or equivalent experience in related field * Major: Business, Marketing, Finance, or Pre-Law preferred * 5 years of work experience beyond degree Skills and Abilities * Healthcare experience with familiarity with emerging trends in contracting and healthcare * Experience negotiating complex contracts; specific experience with IT and/or Operations preferred * Strong negotiation, analytic and problem solving skills * Self-motivated, organized and able to operate with a high degree of autonomy * Ability to manage multiple concurrent, complex tasks and operate at a high level under pressure * Advanced critical thinking and problem solving skills * Enterprise mindset 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: Madison, WI or Minnetonka, MN 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. 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.

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. We are seeking an experienced Underwriter to join our team. In this role, you will be responsible for performing financial analysis, assessing risk, and developing pricing strategies for both new business and renewals. You will collaborate closely with sales teams and occasionally engage directly with client managers to negotiate financial terms. This role applies underwriting guidelines and sound business judgment to develop strategic pricing recommendations that support Medica's financial performance and client retention goals. The ideal candidate will be an experienced underwriter with a strong analytical mindset, confident decision-making skills, and the ability to effectively translate complex data into actionable insights. They will also demonstrate exceptional communication skills and a collaborative approach to working cross-functionally with sales, actuarial, and other business stakeholders. Performs other duties as assigned. Key Accountabilities Conduct detailed financial and risk analyses to determine pricing for new and renewal business in the large group segment Collaborate with Sales to develop renewal strategies and communicate the rationale behind pricing decisions to internal stakeholders and clients Develop and apply an understanding of underwriting risk principles, pricing guidelines, and competitive market trends to support decision-making Complete actuarial and macro-level financial analyses to inform underwriting strategy, pricing policies, and business development initiatives Required Qualifications Bachelor's degree in Finance, Business, Economics, Mathematics or a related field (or equivalent work experience) Minimum of 3 years of underwriting or relevant professional experience post-degree Preferred Qualifications Experience in healthcare underwriting, particularly large group pricing and renewal Proficient in risk assessment and data-driven decision-making Strong proficiency with Microsoft Excel Familiarity with underwriting software and data analytics tools Skills and Abilities Strong analytical and financial modeling skills Solid business acumen and understanding of pricing impact Clear and effective communicator, both written and verbal Confident decision-maker with sound judgment Collaborative team player with cross-functional experience Flexible and adaptable in a fast-paced environment 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 $68,800 - $118,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $68,800 - $103,215. 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.

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. We are seeking a highly experienced and collaborative professional to join our team as a Senior Integration Developer/Engineer. This role is responsible for defining and solving complex technical problems, conducting targeted research, analyzing criteria, and applying effective solutions. The ideal candidate will bring deep expertise in desktop technology operations, enterprise systems management, and cross-functional collaboration-especially within Agile environments and SCCM ecosystems. Performs other duties as assigned. Key Accountabilities * Define, analyze, and review business requirements, system requirements, technical requirements and prioritize tasks * Collaborate with Agile teams, Product Owners, Business Analysts, Scrum Masters, and business stakeholders to gather and understand requirements * Serve as a technical expert in the designing, planning, development, support, and management of various MuleSoft APIs * Lead the implementation, administration, and configuration of the SCCM enterprise environment * Perform routine system maintenance and support the use of defined IT processes and procedures * Conduct root cause analysis and resolve complex technical issues * Coordinate infrastructure problem resolution efforts, including escalation to higher-level support when necessary * Design and support upstream data solutions in collaboration with data engineering teams * Contribute to interface design, solution architecture, and dependency management * Work in a highly collaborative Level 5 environment, ensuring alignment across teams and stakeholders Required Qualifications * Bachelor's degree in a related field or equivalent professional experience * Minimum of 8 years of technical experience beyond the degree Preferred Qualifications * Experience with MuleSoft integration tools * Proficiency in SQL and Oracle databases * Experience in the healthcare industry * Knowledge of EDI (Electronic Data Interchange) and healthcare claims processing * Strong interpersonal skills and a collaborative mindset * Extensive experience with SCCM (System Center Configuration Manager) implementation, administration, and configuration * Strong knowledge of Agile methodologies and experience working in Agile teams * Familiarity with Kafka or similar streaming platforms is a plus * Proven ability to define problems, conduct and narrow research, analyze criteria, and apply effective solutions * Excellent analytical, problem-solving, and communication skills This position is an Office role, which requires an employee to work onsite at our Minnetonka, MN or Madison, WI office, on average, 3 days per week. The full salary grade for this position is $111,200 - $190,600. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $111,200 - $166,740. 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.

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, Treasury & Tax is responsible for overseeing Medica's treasury operations, including daily cash management, ACH and wire transactions, investment monitoring, and resolution of cash processing issues. This role ensures optimal cash flow and return on assets through effective forecasting and modeling, while maintaining compliance with internal policies and external regulations. The manager will lead a team responsible for treasury and tax functions, provide training on banking processes, and collaborate across departments to support payments such as payroll, broker commissions, and provider reimbursements. Strong communication and leadership skills are essential to drive process improvements and maintain high service standards. Perform other duties as assigned. Key Accountabilities * Oversee treasury functions including timely investment of excess funds, approval of wire/ACH transactions, and monitoring of deposits and cash balances. * Lead investment accounting and financial reporting, including daily cash projections and regulatory reporting (e.g., NAIC forms). * Manage Treasury and Tax staff, fostering strong internal and external relationships and driving process improvements. * Ensure compliance with tax regulations and Medica policies, including oversight of filings (990s, 1120s, 1099s) and coordination with internal audit. * Resolve banking and vendor issues, lead ad hoc projects, and develop documentation and plans to support business needs. Required Qualifications * Bachelor's degree in accounting or finance * Minimum of 7 years of relevant experience Preferred Qualifications * Experience in healthcare or insurance industry * Familiarity with NAIC reporting requirements * Prior experience with banking systems and fraud resolution * Supervisory experience * Treasury and tax experience * Proficiency in Microsoft Excel * Strong written, verbal, and interpersonal communication skills * Proven customer service orientation * Demonstrated leadership in a fast-paced environment * Experience managing multiple projects Skills and Abilities: * Ability to model and forecast cash flow effectively * Strong analytical and problem-solving skills * High attention to detail and accuracy * Ability to lead and develop teams * Excellent organizational and time management skills * Ability to communicate across all levels of the organization * Commitment to continuous improvement and cost reduction 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 $98,400 - $168,600. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $98,400 - $147,525. 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.

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. This position is primarily responsible for supporting development and implementation of new business development opportunities and high-impact initiatives withing the organization's growth portfolio. This includes contributing thought leadership, developing market studies, building business cases, and leading the implementation of new business development initiatives; partnering with and influencing business owners to ensure the achievement of expected results, without direct authority. Performs other duties as assigned. Key Accountabilities * Market Research & Growth Investment Planning * Manage intake of market research and data requests; independently develop comprehensive market research and competitive intelligence deliverables * Develop standardized deliverables, production schedules and processes, and ensure ongoing leadership buy-in and alignment * Provide coordination support of key vendor partners and deliverables supporting new business development market research & competitive intelligence * Champion process improvements * Strategic Initiative Business Case Development & Initiative Planning * Contribute to construction of business cases and key business plan inputs, as defined by leader * Contribute to new business development implementation and launch plans based on blueprints of prior expansion work * Strategic Initiative Execution * Proactively identify risks and coordinate development of mitigation action plans * Support team solving key issues Required Qualifications * Bachelor's degree in business, marketing, or healthcare related field, or equivalent experience in related field * 3 years of experience beyond degree Skills and Abilities * Proven track record of success working both independently and working in and leading cross-functional teams, where achieving effective outcomes relies on an ability to collaborate and work cooperatively with others (persuade and influence), rather than on formal reporting hierarchies * Strong communication skills * Experience with and broad knowledge of health insurance industry, business functions and process, products, networks, systems / applications and overall infrastructure * Technical experience building and using data analytics and market research tools, including but not limited to Microsoft Excel, Microsoft Access, SQL, Power BI * Demonstrated project management skills and acumen 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 $$61,500 - $105,400. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $61,500 - $92,190. 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. 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.

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 Client Experience Project Manager is responsible for coordinating client-specific complex issue resolution and ensuring client satisfaction throughout the project lifecycle. This role serves as the primary point of contact for projects and involves cross departmental collaboration, effective communication, and problem solving to manage custom client requests and facilitate new initiatives. Performs other duties as assigned. Key Accountabilities Project Coordination Collaborate with sales, client services, and other departments to coordinate project activities and resource allocation. Manage customer-specific data files, including NDA's and vendor partner data issues. Provide regular updates to stakeholders regarding project status, challenges, and opportunities for process improvement Process Efficiencies and Documentation Drive process improvement initiatives by analyzing and enhancing existing workflows, while also designing and implementing new, efficient processes to support organizational goals Audit Management Lead the oversight for client-specific audits, including claims, utilization management, and mental health parity, partnering closely with the auditors. Reporting Generate and manage complex reporting and handle ad hoc reporting requests to support business decisions RFP Management Serve as the Commercial SME to partner with the RFP writing and documentation teams for existing customer RFP work to ensure compliance with requirements and adherence to deadlines. Required Qualifications Bachelor's degree in Business Administration, Project Management, or equivalent experience in related field 5 years of experience beyond degree Preferred Qualifications Proven experience in project management, preferably in client management or customer service role Strong problem-solving skills with a track record of managing complex issues Excellent communication and interpersonal skills to effectively collaborate with cross-functional teams Experience in managing audits or similar projects is highly desirable Ability to handle multiple projects simultaneously while maintaining attention to detail Proficient in project management tools and software Familiarity with data management, reporting, and compliance standards is a plus Strong analytical and critical thinking skills Excellent organizational and time management abilities Ability to work independently and as part of a team Adaptability to changing client needs and project requirements This position is an Office role, which requires an employee to work onsite at our Madison, WI office, on average, 3 days per week. The full salary grade for this position is $77,100 - $132,200. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $77,100 - $115,710. 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. 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.

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. Medica's Commercial Product Specialist serves as the primary representative for Medica's Self-Funded capabilities within the Capability Review Committee (CRC) and related governance processes. The Commercial Product Specialist coordinates responses for large self-funded clients, including performance guarantees, non-standard requests, and special client requirements. The position also manages annual benefit change processes, including producing and distributing Self-Funded Change Grids for account teams. Performs other duties as assigned. This individual works cross-functionally with Product, Underwriting, Sales, Operations, Technical teams, and Marketing to drive seamless execution of self-funded product strategies and operational changes. Key Accountabilities * Lead coordination of client-specific requests and performance guarantee responses submitted to the Capability Review Committee (CRC) while reviewing and supporting product design changes and customization initiatives * Produce and maintain annual Self-Funded Change Grids for benefit updates and communicate changes to account teams * Participate in workgroups to inform benefit and policy decisions impacting self-funded clients * Support alignment efforts across Commercial and IFB workgroups * Build strong cross-functional relationships with Operations, Technical teams, Underwriting, Sales, and Marketing to execute product changes and client commitments * Monitor and respond to requests from large self-funded clients, ensuring compliance and operational feasibility * Contribute to strategic planning and process improvement initiatives for self-funded product offerings Required Qualifications * Bachelor's degree or equivalent experience in a related field * 5+ years of relevant experience beyond the degree Preferred Qualifications * Project management and communications experience for coordinating complex initiatives * Excel skills for managing CRC data and performance guarantee tracking * Strong attention to detail and ability to manage multiple priorities under tight deadlines * Knowledge of self-funded markets, claims, and benefits administration * Ability to navigate organizational structures and build relationships across multiple teams * Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) * Independent, self-driven professional with strong interpersonal and written communication skills 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, Madison, WI, Omaha, NE, or St. Louis, MO. The full salary grade for this position is $55,400 - $95,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $55,400 - $83,160. 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. 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.

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 Pharmacy Regulatory Manager oversees contractual and regulatory requirements necessary to service Medica's contracts with the Department of Human Services. Includes communication of requirements with affected areas within Medica and vendors by monitoring their activities and through thorough documentation of implementation and compliance activities in accordance with the standards of the Compliance Operations department. Completes all DHS and CMS filings. Serves as Medica's first contact to DHS. Performs other duties assigned. Required Qualifications: * Bachelor's degree or equivalent experience in related field * 5 years of applicable work experience beyond degree including compliance and regulatory experience * 5+ years experience with compliance and regulatory environments 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 $61,500 - $105,400. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $61,500 - $92,190. 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. 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.