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Medica jobs in Minnetonka, MN - 69 jobs

  • Manager, Client Experience

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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, Client Experience, has overall responsibility for Commercial account management service delivery and operational support. This position is critical in the leadership and management of the Account Managers and Account Executives, providing the business and service processes for clients and brokers. This role focuses on retention and membership growth through supporting new business sales and renewal of existing business. Performs other duties as assigned. Key Accountabilities People Management and Team Development Provides day-to-day management of Account Managers and Account Executives including performance management, individual development, career growth, and succession management. Includes daily leadership of staff, goal setting, coaching and development, and annual performance reviews Provides routine assessments and coaching related to performance and regular feedback around team effectiveness, retention of business and service expectations. Facilitates annual employer satisfaction survey and ensures results are consistently favorable; applies market feedback to customized individual and team training needs Accountable for building the team through employee selection, performance management and training. Directs the successful deployment of organizational plans with clients and brokers Coordinates all aspects of training including partnering with operations, product, and shared services teams to ensure the staff is up to date on Medica products, processes and tools Process Improvement and Organizational Support Leads and participates in cross functional work groups to implement organizational initiatives impacting commercial business Identifies and provides prioritization of both Client Support and Medica wide process improvement activities including implementation of compliance initiatives and directives Leads in resolution of escalated client issues Partners with Sales and Operations to address exceptions and customized requests to determine viability, effort, risks, costs and impact. Coordinates with product administration, sales operations, and account teams to achieve retention objectives Provides market (employer and broker) input to product management for new product development, including benefit enhancements, service area expansion, network development, and communication materials Significant Collaborator with External Stakeholders and Internal Leaders Establishes and maintains relationships with key broker partners and clients Represents Medica externally by attending broker and client activities including business events, conferences, training sessions, and other events Partners and builds relationships with other internal and operational departments to coordinate efforts and enhance synergies to improve the customer experience Required Qualifications Bachelor's degree or equivalent combination of education and experience required 5+ years applicable work experience required Skills and Abilities Business expertise and working knowledge of Medica's internal and external sales, operational structure and processes Experience with Association Health Plans (AHPs) and Professional Employer Organizations (PEOs) strongly preferred Demonstrated leadership experience required Ability to build, lead and develop people and teams Strong operational mind-set - able to manage details, projects and process well Strong interpersonal skills (listening, mentoring, motivating) Proven process improvement and problem-solving capabilities Results focused Industry knowledge Strong decision-making ability Effective collaborator Demonstrated successful track record of managing a team handling large commercial/employer clients 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 $92,200-$158,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $92,200 - $138,285. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $92.2k-158k yearly 4d ago
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  • TOC Case Manager III

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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 RN Case Managers provide a member-centered, evidence-based model of care across multiple products. Our Case Management program is responsible for ensuring a smooth and safe transition for members between various care settings. This role involves assessing individual care goals, coordinating medical and supportive services, and connecting members with community resources to support their needs and objectives. Performs other duties as assigned. These actions enable the case manager to reduce the illness burden for individuals and their families while decreasing healthcare costs. Required Qualifications Associate's or Bachelor's degree in Nursing 5+ years of clinical/acute care experience Required Certifications/Licensure Current, unrestricted RN license in the state of residence Certified Case Manager (CCM) preferred, or ability and commitment to obtain within two years of hire required Preferred Qualifications Experience working with vulnerable and complex populations in a clinical, home care or telephonic environment; direct case management experience strongly preferred Experience and at ease working with various populations: multiple age groups, ethnic and socioeconomic backgrounds, medical, surgical backgrounds and a generalized level of understanding across specialty care areas Experience managing multiple computer systems and tools including Microsoft Products and medical documentation platforms Skills and Abilities Professional demeanor: Engaging, persistent and assertive. Empathetic, pragmatic, and prescriptive. General working knowledge of how various health care services link together (the health care continuum) Excels in communication with physicians and health care providers Excellent internal and external customer service skills Strong decision-making skills Ability to think creatively and be comfortable taking the lead in negotiating and accessing resources Ability to have positive impact on team by modeling and supporting change Understand, articulate and support the organization's mission, vision, goals and strategy Work efficiently towards department benchmarks Excellent verbal and written skills and the ability to present in a group setting Ability to work positively in a fluid, ever-changing environment Ability to thrive in a fast-paced setting, make decisions under stress, and manage multiple complex issues on a daily basis This position is a Remote role.To be eligible for consideration, candidates must have a primary home address located within any state where Medica is registered as an employer - AR, AZ, FL, GA, IA, IL, KS, KY, MD, ME, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WI The full salary grade for this position is $72,100 - $123,600. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $72,100 - $97,850. 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. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $72.1k-123.6k yearly 4d ago
  • Provider Connectivity Epic Payer Platform Analyst

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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 Maintaining and updating our system (MEPPI) configuration Monitoring our provider connections and statistical dashboards in Epic for system issues and anomalies System upgrades: Install, regression testing, 'data courier' upgrades through our environments (Data Courier requires Epic certification which we can provide) Configuration and testing support for new provider connections Care Everywhere support for user and provider connectivity User support, managing access to AD and MEPPI instance Setting up and training new users Trouble shooting users access issues 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 $88,800 - $152,300. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $88,800 - $133,245. 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. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $88.8k-152.3k yearly 4d ago
  • Data Analyst/Systems & Business Analyst

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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 $88,800 - $152,300. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $88,800 - $133,245. 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. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $88.8k-152.3k yearly 4d ago
  • Creative Project Manager

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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 Creative Project Manager is responsible for all aspects of the development and implementation of assigned projects and or initiatives and provides a single point of contact for those projects. Provides subject matter expertise based on established project management techniques. Performs other duties as assigned. Key Accountabilities Project Management: Manage workflow and deliverables Daily management of tasks in the workflow tool Facilitate weekly status meetings and review status reports Report project status to stakeholders and team; help eliminate roadblocks and identify solutions for projects that are off track Ensure Robohead accountability with partners Facilitate forward-planning meetings with business partners to identify upcoming work, prioritize current work, and address bottlenecks Coordinate weekly creative reviews and traffic circulation/review process Support coordination of assets Coordinate retrospectives for significant projects or to address issues Assess current processes and provide recommendations for improvement Workflow Management: Manage intake, resource assignments, and schedule work reviews Ensure Robohead adherence and provide training to maintain complete and up-to-date project documentation Review all requests to confirm necessary information is complete Coordinate and assign work to designers and writers Schedule necessary meetings and reviews Review the level of work required for projects (tier projects) Provide reporting on team capacity, efficiency, and success in meeting deadlines Ensure standardized project timing and processes across design and copy teams Key Initiatives Support: Ensure seamless execution and provide reporting for key creative deliverables Provide summaries of accomplishments, risks, and progress for creative deliverables for OEP/AEP and 1/1 readiness Coordinate and manage creative deliverables for key brand touchpoints such as the Medica Magazine and Annual Report Establish and govern consistent job naming conventions and file/folder hierarchy Partner with the MDAC librarian on process, training, tools, and governance to ensure efficient and consistent access to creative assets and deliverables in the Digital Asset Library Required Qualifications Bachelor's degree or equivalent combination of education and work experience 3+ years of related experience, including demonstrated project management experience Skills and Abilities Experience driving deliverables across all media types, including print, video, digital, and OOH Experience managing projects using workflow software (Robohead, Workfront) Demonstrated success driving execution and managing complex efforts to meet time and budget targets Expert communicator, capable and confident working with all levels of stakeholders Detail-oriented and able to quickly pivot to address changing timelines or requirements Comfortable with ambiguity 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 $78,700 - $134,900. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $78,700 - $118,020. 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. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $78.7k-134.9k yearly 4d ago
  • Actuarial Associate

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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 Actuarial Associate will 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. Key Accountabilities Conduct and interpret actuarial analyses, valuations, and cost estimates Perform rate level pricing functions and prepare monitoring reports Use statistical programming and database tools for modeling and forecasting Analyze historical data to identify trends and develop future projections Apply actuarial principles to complex projects with moderate decision-making authority Recommend new projects and work procedures to improve team or unit performance Contribute to team objectives and influence functional goals through professional expertise Serve as a resource to others and support cross-functional collaboration The successful candidate will possess strong analytical and statistical skills, demonstrate independent judgment, and have a proven ability to manage complex projects. They will be a collaborative team player who communicates effectively and contributes to continuous improvement and innovation. Minimum Qualifications Bachelor's degree or equivalent experience in a related field 5 years of work experience beyond degree Associate of the Society of Actuaries (ASA) designation Strongly Preferred Qualifications Experience in healthcare or insurance actuarial work Advanced proficiency in statistical programming and database tools Knowledge of ACA Individual or Small Group pricing Skills and Abilities Proficiency in actuarial analysis and modeling techniques Strong statistical and analytical skills Ability to interpret complex data and communicate findings effectively Skilled in using statistical programming and database tool Capable of working independently and managing multiple priorities Effective decision-making and problem-solving abilities Strong collaboration and 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, or Madison, WI. The full salary grade for this position is $88,800 - $152,300. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $88,800 - $126,900. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $88.8k-152.3k yearly 5d ago
  • Payroll Analyst

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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 Payroll Analyst is responsible for the accurate, timely, and compliant processing of payroll. This role focuses on payroll execution, validation, reconciliation, reporting, and employee support, ensuring a high level of service and regulatory compliance. Performs other duties as assigned. Key Accountabilities Payroll Processing & Execution Process regular and offcycle payrolls using UKG, ensuring accuracy of earnings, deductions, taxes, and net pay Validate payroll inputs from timekeeping (UKG Dimensions), HR events (new hires, terms, leaves), and benefit changes Review pre and postpay reports to identify and correct discrepancies Reconciliation & Compliance Reconcile payroll results to funding files, general ledger entries, and payroll reports Ensure compliance with federal, state, and local payroll laws and tax regulations Support yearend activities including W2 processing and tax reconciliations Employee & Partner Support Research and resolve payroll inquiries related to pay, taxes, garnishments, and deductions Partner with HR, Benefits, and Finance teams on payrollrelated events Communicate payrollrelated information clearly and professionally to employees Reporting & Controls Prepare payroll reports, audit documentation, and control evidence Execute established payroll controls and document results Participate in payroll testing during system updates or process changes Continuous Improvement Identify opportunities to improve payroll accuracy, efficiency, and documentation Contribute to updates of payroll procedures Required Qualifications Bachelor's degree in Accounting, Finance, Human Resources, or equivalent experience in related field 3 years of work experience beyond degree Preferred Qualifications Fundamental Payroll Certification (FPC) or Certified Payroll Professional (CPP) Experience with UKG Pro Payroll, UKG Dimensions Multistate payroll experience Advanced Excel skills Skills and Abilities Understanding of payroll tax and wage compliance High attention to detail and ability to meet processing deadlines Strong customer service and 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 $70,200 - $120,400. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $70,200 - $105,315. 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. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $70.2k-120.4k yearly 2d ago
  • Manager of Provider Reimbursement

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. The Manager of Provider Reimbursement leads the management of the fee schedule development, contract modeling, and implementation processes in provider finance. The Manager documents processes, dependencies, and tools to maintain Medica's provider fee schedules and works with stakeholders on identifying refinement opportunities. Additionally, the Manager supports contract model data inputs, stewardship of provider finance data, and works with stakeholders to identify opportunities to improve model functionality, efficiency, and accuracy. The Manager coordinates projects that involve/impact multiple teams and departments. The Manager monitors unit progress toward goals, assists in department planning, and prioritization. The manager assists in the successful operation of the provider finance department. The incumbent ensures that processes and policies are followed to produce high quality results. The Manager proactively engages in identified opportunities and facilitates solutions with various stakeholders. Performs other duties as assigned. Key Accountabilities Fee Management Schedule Provides fee schedule development and implementation including uploading new fee schedules, tracking fee schedule activity, and facilitating fee schedule provider renewal impacts and coding updates Documents processes, dependencies, and tools to maintain fee schedules in Medica's provider reimbursement payment platforms Works with stakeholders to refine methods and processes in the development and implementation of provider fee schedules management Contract Model & Data Management Supports provider contract modeling solutions and contract modeling inputs including but not limited to Data Pac inputs Works 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 leads efforts focused on data stewardship and best practices Leadership Activities Interacts heavily with other departments in a leadership role. Builds strong relationships with groups across the organization: including: Network Management, Provider Network Operations, and IT Training and mentoring of team members Additional Projects Provides support to network management strategic initiatives Assists with other provider finance activities such as supporting Medical Expense Committee, Reimbursement Committee, & commercial RFPs Required Qualifications Bachelor's degree or equivalent experience in related field 5 years of experience beyond degree Strongly Preferred Qualifications Minimum 4 years of Healthcare Reimbursement experience Minimum 4 years of experience working with health care claims data Preferred 4 years of Oracle, SAS, and/ or SQL experience Skills and Abilities Professional experience in data and process management Knowledge of claims systems and related claims payment methodologies Excellent interpersonal skills; ability to work with all levels of management on a variety of financial issues Ability to analyze, coordinate, and document numerous projects Excellent communication and 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, Madison, WI, Omaha, NE, or St. Louis, MO. The full salary grade for this position is $100,300 - $172,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $100,300 - $150,465. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $100.3k-172k yearly 4d ago
  • Data Governance Lead, Stewardship

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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 Data Governance Lead - Stewardship is a key contributor to the definition, implementation and evolution of Medica's stewardship strategy and model, with a primary focus on the Data Catalog Program. This role helps build, mature and support data governance, stewardship and quality programs, leveraging technical expertise and leadership skills to drive adoption and integration of governance practices across the organization. The Lead acts as Stewardship Lead for the data catalog, ensuring consistency, alignment, and continuous improvement. Performs other duties as assigned. Key Accountabilities Serve as Stewardship Lead for the data catalog, defining standards, processes, and role expectations Build and mature data governance and quality programs, leveraging technical expertise and leadership skills Onboard and support Business Curators and Domain Knowledge Partners; monitor stewardship activity for consistency Develop and maintain stewardship dashboards, reporting on progress and catalog quality metrics Facilitate alignment between stewardship activities and enterprise governance goals, participate in the Data Governance Stewardship Council Gather feedback on stewardship processes and implement improvements Create and oversee the implementation of a data steward communication and support plan Influence adoption of governance practices through communication, technology enablement, and integration into development workflows Explore and leverage AI capabilities and automation opportunities to enhance governance and quality programs Required Qualifications Bachelor's degree or equivalent experience in related field 7 years of work experience beyond degree Skills and Abilities Proven experience in building and maturing data governance and stewardship programs Strong technical data skills; experience with data catalog tools and governance frameworks Leadership experience with the ability to persuade and influence across the organization Health insurance data knowledge preferred; aptitude and curiosity to learn Medica's data required Familiarity with AI applications in data governance is a plus Familiarity or experience with data quality programs preferred 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 $88,800 - $152,300. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $88,800 - $133,245. 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. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $88.8k-152.3k yearly 4d ago
  • Health Transformation Consultant

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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 Health Transformation Consultant is an advanced-level professional who consults with external clients to plan, develop, implement, and monitor engaging wellbeing initiatives and programs. Leveraging a multi-dimensional wellbeing model, data analysis, and industry best practices, this role ensures that programs and tools for leaders and employees translate into effective practices, fostering a thriving organizational culture and climate. The position will also provide group or member face-to-face or virtual sessions focused on education, goal setting, and developing strategies to overcome obstacles and barriers to success. The position provides direction to other staff and handles advanced responsibilities with minimal supervision, making a significant impact on business objectives and team processes. Performs other duties as assigned. Key Accountabilities Consult with external clients to design and implement wellbeing initiatives and programs. Apply a multi-dimensional well-being model to ensure effective practices and a positive organizational climate. Monitor and evaluate the success of wellbeing programs and tools for leaders and employees. Provide direction and guidance to other staff members. Contribute significantly to team processes and business objectives. Exercise latitude in decision-making for complex projects within the professional area. Direct team members to achieve unit goals. Maintain regularly assigned work schedule. Help individuals gain insights that lead to high program satisfaction and measurable health outcomes. Utilize evidence-based behavioral strategies to support lasting change Required Qualifications Bachelor's degree or equivalent experience in related field 7 years of work experience beyond degree Preferred Qualifications Master's degree in related field Experience consulting with external clients in wellbeing or related fields Demonstrated ability to lead and direct teams on complex projects Critical Incident Stress Management, health coaching, motivational interviewing certification/training 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 $70,200 - $120,400. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $70,200 - $105,315. 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. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $70.2k-120.4k yearly 4d ago
  • HL7 Developer/IT Engineer - Health Share

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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. Defining problems, conducting and narrowing research, analyzing criteria, finding, analyzing and applying solutions. Performs other duties as assigned. Key Accountabilities Work with Lead Developers on implementation of changes related to our ecosystem surrounding Health Share product by Intersystems Develop and maintain interfaces using Health Share IRIS and ObjectScript Interpretation and implementation of data transformations and mappings using HL7, CDA/CCD, FHIR, JSON. XML. Resolve integration issues, configuration and other changes through Health Share toolset High level understanding of Interoperability standards Document technical specifications, workflows and test plans Support continuous improvement through automation and best practices. Required Qualifications Bachelor's degree or equivalent experience in related field 5 years of work experience beyond degree Role requirements: 3+ years of experience with InterSystems HealthShare, or IRIS. Strong ObjectScript programming skills. Proficiency in healthcare data standards (HL7, FHIR, CDA, C-CDA). Experience with integration protocols (MLLP, REST, SOAP, SFTP). Solid understanding of SQL and relational databases. Familiarity with healthcare compliance (HIPAA) and interoperability concepts. Preferred Qualifications Experience with EMR/EHR systems (Epic, Cerner, etc.). Knowledge of cloud platforms (AWS, Azure, GCP). InterSystems certification (HL7 Interface Specialist or similar). 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 $102,100 - $175,100. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $102,100 - $138,605. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $102.1k-175.1k yearly 4d ago
  • Epic Program Manager V

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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 Services program. Owns the end-to-end implementation of Epic Payer Platform capabilities to Health System partners. Supports internal business owners and coordinates with IT partners for downstream capabilities. Supports platform configuration for new and existing capabilities. Responsible for internal program success reporting and external value reporting for providers. Responsible for managing highly visible Epic projects that cross multiple business and IT areas. This role must partner with Epic, 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 Recruits and implements new customers Responsible for expanding current capabilities and implementing new capabilities on 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 to support current use cases and to help develop additional use cases Providers leadership and support with our vendor Epic Ensure strong Epic program governance which includes proactive risk and issue management and reporting Responsible for tracking and measurement of internal program success and individual health system value propositions Required Qualifications Bachelor's degree or equivalent experience in related field 8+ years of work experience beyond degree Preferred Qualifications 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, St. Louis, MO. The full salary grade for this position is $100,300 - $172,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $100,300 - $150,465. 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. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $100.3k-172k yearly 3d ago
  • Health Plan Developer III

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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 Enterprise Analytics department is looking for a talented and enthusiastic individual to join our team as a senior business intelligence developer. The ideal candidate will have significant health insurance experience, strong business intelligence expertise, and excellent communication abilities. You will work directly with our stakeholders to understand requirements for dashboards, reports and analyses. You should have direct experience with either Power BI or the Qlik Sense BI platform or be willing and able to become proficient quickly. This is a senior level position that will take on complex responsibilities with minimal supervision and will serve as a resource to others on the team. Performs other duties as assigned. Key Accountabilities Build excellent relationships with customers of our team as you work to understand requirements and design solutions for needed dashboards, reports and analyses Develop a deep understanding of Medica's data warehouse and other data sources Design and develop new dashboards and reporting applications from end to end (data loading/modeling, reports, and visualizations) Maintain and update existing dashboards Assist in team project planning / project-managemen Required Qualifications Bachelor's degree or equivalent experience in computer science, mathematics, information systems, software engineering, or related field 5+ years of work experience beyond degree Preferred Qualifications Substantial work with BI tools and data visualization/reporting Experience with health insurance data and analytics Advanced proficiency writing SQL Understanding of data warehouse concepts (star schemas, joins, indexes, etc.) Strong communication skills and experience working with a team The ability to work both collaboratively and independently Experience with Snowflake data warehouse Experience with SAS Experience with Oracle Analytics or Oracle Business Intelligence Experience using Git for version control and collaborating using tools like GitHub, GitLab 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 $102,100 - $175,100. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $102,100 - $145,900. 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 Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $102.1k-175.1k yearly 4d ago
  • Regulatory Adherence Analyst

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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. 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 contract adherence activities in accordance with Medica standards. Submits regulatory reports to DHS, responds to internal inquiries and DHS inquiries following Medica Regulatory Adherence team process. Performs other duties as assigned. Key Accountabilities Track State Medicaid Regulatory Requirements Communicate regulatory changes to internal teams, track adherence to new requirements Review and submit materials to State Medicaid agency Conduct quality check and submit reports as assigned Required Qualifications Bachelor's degree or equivalent experience in related field 3 years of work experience beyond degree 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 $56,600 - $97,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $56,600 - $84,840. 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. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $56.6k-97k yearly 4d ago
  • Internal Sales Consultant I/II/III ETF | Flex

    Allianz 4.9company rating

    Minneapolis, MN job

    What you do: Internal Sales Consultant I/II/III is to increase sales of Allianz products through direct contact with financial professionals and lead generation. You will report to the ETF Sales Desk Manager. Activity and Results: Meet and exceed revenue and activity performance benchmarks: dials, conversations, leads, new adviser activations, retention, and sales. Utilize each contact as an opportunity to build a relationship and understand how to provide value to the adviser's business. Utilize database and other tracking methods to track advisor production levels on current and proposed sales activity. Time Management: Effective use of the day supporting primarily inbound phone coverage. Be responsive and proactive in contacting current and prospective advisers in order to retain and help grow their utilization of Allianz's offerings. Territory Management: 1) Manage workload and external partner(s) relationships expectations to reach goals. 2) Establish profile information and qualify advisors business focus. 3) Leverage external wholesaling partnership and value by effectively communicating and coordination. Sales Effectiveness: Ability to be a professional inside salesperson that advances the sales process. Promote/sell Allianz products and solutions by way of a consultative sales approach. Work with advisers through various roadblocks that occur when recommending Allianz solutions. Utilization of artificial intelligence tools and resources (e.g. generative AI). What you bring: * < 1 years of experience required including prior sales experience * Four year degree or equivalent work experience required * FINRA SIE, Series 7, 63 or ability to obtain within 90 business days of hire * Ability to work during the hours of 7:00 am - 6:00 pm CST * Comfortable with talking on the phone as their primary activity * Ability to attend evening business functions * Potential to travel on a limited basis * You must be legally authorized to work in the U.S. without requiring immigration sponsorship now or in the future. This includes holders of H-1B, H4, L-1, L-2, TN, OPT, CPT, and other nonimmigrant visas. Internal Sales Consultant I ETF job posting Range: $45,000 - $50,000 Internal Sales Consultant II ETF job posting Range: $54,000 - $60,000 Internal Sales Consultant III ETF job posting Range: $58,500 - $65,000 Note the job posting range is exclusive of company benefits or other compensation. If you are hired, your final base salary will be determined based on factors such as geographic location, experience, skills, competencies, and/or education. In addition to those factors, we will also consider internal equity of our current employees. Please keep in mind that the range provided is the full base salary range for the role. Hiring at or near the maximum of the range would not be typical to allow for future and continued salary growth. This role is also eligible for a variable compensation program. The actual variable compensation earned is driven by assigned territory and individual sales performance. 86460 | Sales & Distribution | Professional | Non-Executive | Allianz US Life | Full-Time | Permanent What we offer: At Allianz Life, we're proud to provide a benefits package that supports the True Balance of our employees and their families. We offer: a choice of comprehensive medical, dental and vision plan options, flexible spending and health savings accounts, tuition reimbursement, student loan retirement program, generous annual paid leave, an outstanding 401(k) company match, and life insurance. Plus, our employees enjoy an award-winning campus with an array of discounted amenities, including an onsite health center, child development center, fitness facility, convenience store and two cafeterias. Our employees and leaders take an active role in shaping our culture through our Employee Resource Groups, whose activities and advocacy contribute to an environment that is fair, caring, and inclusive. Our generous benefits, campus amenities and inclusive, engaged culture are among the many reasons we're routinely recognized as a top workplace employer. For additional information regarding What It's Like To Work Here | Allianz Life. Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us. At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. And the foundation for this is our inclusive workplace, where people and performance both matter, and nurtures a culture grounded in integrity, fairness, inclusion and trust. We therefore welcome applications regardless of race, ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations. Join us. Let's care for tomorrow. #LI-BLS#LI-
    $58.5k-65k yearly 58d ago
  • Product Implementation Analyst

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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 Product Implementation Analyst at Medica is responsible for supporting systems and processes related to product development, implementation, and certain renewal activities. This role serves as a key resource for business leaders and managers by defining requirements and performing implementation tasks across all lines of business. The analyst works collaboratively with product line teams and other business and technical areas to ensure that all necessary information for managing product lines and installing new products or variations is properly identified, managed, and tested through relevant systems and processes. The analyst acts as a subject matter resource for efforts involving key systems or processes, such as loading products or rates into core systems, subsystems, or partner systems. Responsibilities include providing input on project plans-such as estimates, timing, and dependencies-and maintaining documentation required for implementation processes and procedures. Additional duties include system research, analysis, documentation, ad hoc reporting, and vendor or partner implementation and testing activities as needed. The analyst must understand how products and rates interact with other areas, including actuarial, underwriting, benefits, claims, and finance, and support systems for tracking business results. This role may also assist with financial or business metrics aimed at monitoring product lines and scorecards. Key Accountabilities Assist in developing and maintaining the product implementation lifecycle, including requirements, test design, test execution, and documentation. Support day-to-day activities related to product development and implementation Represent product implementation on small to medium-sized projects under supervisor oversight Serve as a subject matter expert in exporting plan, rate, and product business rules to external systems. Perform analysis on external systems to understand integration requirements Support new product implementation by building and testing new business products and rate activities. Act as a key resource for configuration activities in support systems for product and rating, including launching new rating algorithms and rate tables Contribute to the development of standard methodologies and repeatable processes for upgrades, changes, and annual product cycles. Assist with renewal implementation efforts by building and testing existing product and rate activities and completing product line documentation as needed Design and execute testing of rates and product attributes. Act as a thought leader in analysis and testing techniques, streamlining workflows. Serve as a key resource for testing QHP and other filings, reviewing plan previews, and other testing scenarios. May review outsourced results, internal systems, and execute configuration or testing tasks as assigned Function as a go-to resource for designing workflows and methodologies to manage data and ensure quality Participate in customer experience projects, identify issues, and collaborate with business areas and the organization to improve customer satisfaction Act as a subject matter expert for product-related implementation teams and support product input for submissions to CMS or other vendors across all lines of business Conduct research, documentation, and implementation activities to support business-wide decision-making Perform other duties as assigned Required Qualifications Bachelor's degree or equivalent experience in a related field Seven years of work experience beyond the degree Preferred Qualifications At least two years of experience in healthcare, insurance, financial, or software environments requiring significant system knowledge, preferably as a business analyst, systems analyst, or in a system configuration role Background in data analytics, sales reporting, implementations, software vendors, training, underwriting, or project management Proven problem-solving skills and ability to analyze processes and system-related issues Ability to work effectively with managers and across the organization Excellent verbal and written communication skills with strong attention to detail Ability to manage multiple tasks with strict deadlines Knowledge of health insurance and/or Medicare products Previous experience working on cross-functional teams Familiarity with standards or practices related to systems and system support 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 $62,700 - $107,500. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $62,700 - $94,080. 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. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $62.7k-107.5k yearly 4d ago
  • Senior Risk Engineer II - Property

    Allianz 4.9company rating

    Minneapolis, MN job

    Your Team Allianz Commercial specializes in property insurance for middle-market and large companies, providing comprehensive coverage for complex and challenging risks. Through our global network, we offer tailored all-risks property and business interruption insurance. Our Allianz Risk Consulting (ARC) team is made up of experienced engineers from a wide range of technical and scientific disciplines. The team provides a flexible range of risk consulting services, from natural hazards, fire safety, and human and organizational risk factors to in-depth analysis of industry operations, and financial exposures, across all industry sectors and risks. We also focus on delivering bespoke training plans to help our clients to optimize risk management procedures in the long term. The Impact You Will Have Reporting to the Property Manager AE, this role provides Property Risk Engineering expertise and support to Allianz Commercial and its customers, to assist Allianz Commercial Underwriting in risk selection and retention of accounts. Responsibilities include both Field Engineering (on-site/location level risk evaluation) and Account Engineering (account level/desktop review) risk assessment job activities, such as providing ongoing co-ordination and monitoring of the loss control activity / servicing of assigned accounts within the Midwest geographic region and/or area of technical expertise. This is a client-facing role, and the successful candidate should demonstrate the ability to develop and maintain collaborative and professional relationships with a wide range of stakeholders, including underwriting teams, peer experts, brokers, clients, marketing and distribution teams, claims departments, and colleagues across the globe. Additionally, maintaining and enhancing technical skills and expertise in their specific field or specialty is crucial to effectively support the business. The role also requires the ability to creatively apply risk engineering knowledge and technologies like data analysis, modeling, and AI to solve problems. This involves offering predefined services and developing customized solutions to meet client risk engineering and mitigation needs. Finally, the candidate must be adaptable to changes in business needs, systems, tools, processes, and technological developments, ensuring they can effectively respond to evolving challenges and opportunities. This is a remote position and requires approximately 30% travel for field surveys, client meetings and potential collaboration with underwriting colleagues in zone offices. Some of your specific responsibilities could include: * Independently support large corporate clients or clients with complex business occupancies and structures. Complete on-site field engineering survey assessments and plan reviews for underwriting and insureds, evaluating and summarizing exposures and controls. Complete account level overviews, desk top reviews and risk assessments to support zone and regional underwriting efforts, providing guidance and professional advice to clients and underwriting from both a location-level and a holistic, program-wide perspective. Experience in a variety of occupancies, including both manufacturing and soft sectors, is necessary. * Survey large client operations in all business segments - obtain appropriate data, identify hazards, discuss findings with appropriate parties, and generate comprehensive risk engineering reports, recommendations, etc. Work with underwriting, the client and broker to develop appropriate value-added solutions through tailored loss control programs and services, including development of scope and cost of risk consulting services. Conduct client stewardship meetings, promote and technically support ARC services and solutions, and foster client interaction with the objective of enhancing client resilience by mitigating property loss potentials. Work with claims post loss as required. * Generate appropriate, technically accurate work product (Account Engineering annual account summaries, Prospect desktop reviews, risk engineering survey reports, recommendations, confirmation letters, etc.) as a result of account engineering, survey and service activities. Conduct all work in accordance with Account Service Instructions / Global Standard Operating Procedure requirements and reporting deadlines in alignment with departmental performance objectives. Ensure appropriate data entry and quality in accordance with GSOP and management requirements. * This position requires good time management, organization and communication skills with both internal and external customers. The successful candidate must be able to balance field survey and prospect/account review and coordination workload demands, as well as regular meetings and interactions with clients and underwriting. Daily workflow may require communication with third party service providers, clients, brokers, insured risk management department personnel, underwriting, peers, etc. Good, proactive communication skills, along with appropriate follow-up activities with relevant parties, are needed to maintain smooth and efficient workflow. * Assist Allianz Commercial and clients with respect to ongoing or specific projects. Support with relevant expertise additional ARC Services and be able to articulate and adapt these as potential solutions to client concerns especially in enhancing operational resilience. Participate in Segment Expert Teams and other ARC initiatives, as well as ARC Global (inter-regional), cross-LoB and/or cross-functional projects as warranted. Assist with training and presentations to clients, industry groups, and within ARC Corporate Property, other LoB's and in support of other functions (e.g. underwriting) as requested. What You'll Bring to the Role - * Minimum 5 years' loss prevention engineering experience in an HPR type insurance environment relevant to the LoB (Property). Good knowledge and professional experience in various business sectors, related hazards and associated protection/controls. * Experience or background in managing/coordinating large global corporate property accounts within various occupancy sectors. Experience in specialist industries (semi-conductor, chemical/pharmaceutical, automotive) or hazards (Nat-Cat, BI/IBI/CBI/supply chain, emerging risks) is a plus. * Experience or background in the property insurance industry - understanding the language of insurance and technical aspects of property risk engineering. * Bachelor's degree in Fire Protection Engineering or engineering type discipline (i.e. Civil, Chemical, Industrial, Mechanical). * Bachelor's degree in another related discipline will be considered in conjunction with extensive technical expertise or experience in HPR insurance industry. * Demonstrate great engineering/technical expertise in Property Risk Engineering, as well as strong familiarity with a variety of occupancies and the associated hazards. * Strong familiarity with Fire Protection guidelines, such as NFPA or FM Global. Commitment to maintaining knowledge of developments and new technologies in field. * Ability to understand and apply technical loss control concepts to a variety of property risks and promote various ARC services as potential solutions for customer concerns. * Self-motivated, with the ability to work effectively in both home office and team environments. Proactive change agent, adapting with ease and promoting among peers the adoption of new technologies, processes and working methods. * Excellent written, verbal and presentation skills. * Ability to travel throughout the US, with the potential for some Canada or international travel. * Good knowledge of the MS365 environment, AI tools, data analytics and and visualization techniques as well as NATCAT modeling principles * The ability to utilize AI tools to support day-today tasks, improve efficiency, and contribute to data-driven decision-making is valuable. A willingness to learn and explore how AI can enhance your role and the broader organization is expected. External applicants must be legally authorized to work in the United States without the need for current or future employment-based sponsorship. We are unable to sponsor or take over sponsorship of employment visas at this time, nor can we guarantee future sponsorship. The annualized base pay range for this role is $102,183 to $170,509. The annual base salary range represents a nationwide market range. The actual salary for this position may be above and will be determined by several factors, including the scope, complexity and location of the role, the skills, education, training, credentials, and experience of the candidate. The base pay is just one component of the AzC total compensation package. As part of our comprehensive compensation and highly rated benefits programs, employees are also eligible for annual performance-based cash incentive awards. What's in it for you? At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. And the foundation for this is our inclusive workplace, where people and performance both matters, and nurture a culture grounded in integrity, fairness, inclusion and trust. We therefore welcome applications regardless of race, ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations. Let's care about everything that makes you, you We are committed to nurturing an inclusive environment where everyone feels they belong. We offer a hybrid working model, which recognizes the value of striking a balance between in-person collaboration and remote working. Please feel free to discuss flexible working arrangements with us. Let's care for your financial wellbeing We believe in rewarding performance with a great compensation and benefits package (details vary by location), including a generous bonus scheme and pension. Let's care for your opportunities to progress From career development and digital learning programs to international career mobility, we offer lifelong learning for our employees worldwide and an environment where innovation, delivery and empowerment are fostered. Let's care for life's twists and turns From our support for flexible working, health, and wellbeing (including private healthcare and generous parental leave benefits), to helping people return from career breaks with experience that nothing else can teach. We've got your back. Let's care for our society and our planet With opportunities to be engaged in shaping a future that is safe, inclusive, and sustainable, we care for the tomorrows of our people, our industry, and our clients. Care to join us? Allianz Commercial (AzC) is a global corporate insurance carrier and part of Allianz Group. We provide risk consultancy, Property-Casualty insurance solutions and alternative risk transfer for a wide spectrum of commercial, corporate and specialty risks across 10 dedicated lines of business. Learn more about us by clicking here. Allianz is an equal opportunity employer, and therefore welcomes applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability, sexual orientation, or any other protected characteristic. Diversity of thinking is an important part of our company culture. Recruitment Agencies: AzC has an in-house recruitment team, which focuses on sourcing great candidates directly. AzC does not accept unsolicited resumes from agency or search firm recruiters. Fees will not be paid in the event a candidate submitted by a recruiter without an agreement in place is hired. When we do use agencies, we have a PSL in place, so please do not contact managers directly. Failure to comply could/may result in the disqualification of the candidates and/or the termination of our contract and/or fees not being paid. #LI-PT1 #LI-Remote
    $102.2k-170.5k yearly 9d ago
  • County Engagement Manager

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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 County Engagement Manager serves as a key representative of Medica and its Medicaid programs, responsible for building and strengthening relationships with counties, community partners, and members across the service area. This role promotes Medica's services, participates in regional workgroups, and supports community engagement initiatives designed to improve the lives of members. Perform other duties as assigned. Key Accountabilities Represent Medica at county meetings, health fairs, conferences, public forums, and community events. Develop, organize, and facilitate meetings, discussion groups, and special events. Identify and cultivate partnerships to expand outreach and strengthen relationships with counties and community partners. Share insights and learnings with Medica leadership on issues important to counties and supporting organizations. Maintain detailed records of member and county engagement, contacts, and outreach activities within Medica's CRM platform. Required Qualifications Bachelor's degree in a related field or equivalent experience. Minimum of 5 years of experience in county relations, public health, social services, community outreach, or advocacy. Preferred Qualifications Experience in community outreach, public health, or social services with demonstrated relationship-building strength. 2+ years of relationship management experience with providers, counties, community health organizations, or tribal nations. Understanding of healthcare and managed care, including Medicaid, Medicare, and Indian Health Service. Experience attending public events in various weather conditions and standing/sitting for extended periods. Strong interpersonal, public speaking, and presentation skills; ability to engage diverse populations. Ability to work independently and collaboratively across teams. Strong organizational skills with the ability to multitask effectively. Proficiency in Microsoft Office (Word, Excel, Teams, PowerPoint) and virtual meeting platforms (WebEx, Zoom). Cultural competency and understanding of Healthy Communities principles. Ability to maintain a regularly assigned work schedule. Skills and Abilities: Strong relationship-building and community engagement skills. Ability to represent Medica effectively in public forums and with diverse community groups. Excellent communication skills, including public speaking and facilitation. High level of cultural awareness and ability to engage with diverse populations. Strong organization, attention to detail, and documentation skills. Ability to work both independently and collaboratively across teams. Comfort working in varied environments, including community settings and outdoor events. This position is a Remote role.To be eligible for consideration, candidates must reside within the state of MN. The full salary grade for this position is $62,700 - $107,500. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $62,700 - $94,080. 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. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $62.7k-107.5k yearly 2d ago
  • Commercial Product Specialist II, Small Group and Level Funded

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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 II, Small Group and Level Funded, is responsible for collaborating with the Commercial Product team and internal departments on the development and deployment of new and existing Small Group and Level Funded products. This role will complete product analysis, implementation activities, research product/program challenges, and identify trends for improvements that are incorporated into a 3-5 year roadmap. Performs other duties as assigned. Key Accountabilities Collaborates with Underwriting, Actuary, Legal, and Regulatory teams during the product life cycle Develops training materials for brokers and sales teams Maintains and updates product grids Engages with functional and matrix partners (Regulatory, Legal, Sales, Product, Marketing) Enhances product performance and supports growth goals Reviews customization requests related to product design Conducts market segment research Monitors trends using internal and external resources Assists with gathering and executing product requirements Partners with Underwriting and Actuary teams for rating and pricing Considers overall customer experience and product performance Collaborates with Product Managers to provide recommendations Supports other product segments as needed (Fully Insured, Self-funded) Performs other duties as assigned Works collaboratively and effectively communicates with the product team Identifies process improvements Develops templates, workflows, and process documentation The Product Specialist reports to the Manager of Small Group and Level Funded Products and works with internal stakeholders within Actuary, Underwriting, Finance, Legal, Regulatory, Sales, and Marketing. Required Qualifications Bachelor's degree or equivalent experience in a related field 3+ years of related experience beyond the degree Preferred Qualifications Knowledge of Small Group actuarial values, ACA and CMS guidelines, and products Understanding of Level Funded cost structure (stop-loss insurance, claims, and admin fees) and products Understanding of the overall customer experience and the product performance lifecycle Ability to support other product segments Ability to perform tactical execution, identify areas of process improvement, and streamline processes Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) Detail-oriented Strong interpersonal skills, with strong written and verbal communication skills Ability to manage competing priorities and meet tight deadlines Independent, self-driven professional 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 $50,800 - $87,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $50,800 - $76,125. 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. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $50.8k-87k yearly 4d ago
  • Provider Network Consultant II

    Medica 4.7company rating

    Medica job in Minnetonka, MN

    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. Provider Network Consultant develops and maintains assigned provider relationships. Reviews provider requests for inclusion in assigned territories and assists in analyzing impact to determine approval. Manages on-going provider needs relative to program roll-outs and medical policy change communication. Provides onboarding education/outreach, handles provider appeals, and resolves escalated provider issues. Ensures that provider data is accurate. Required Qualifications Bachelor's degree or equivalent experience in related field 3 years of health plan or provider experience Skills and Abilities Advanced level Microsoft Excel skills Experience with claims operations and various reimbursement methodologies strongly preferred Experience managing and loading provider rosters preferred Strong attention to detail Aptitude to learn multiple systems Strong written and verbal communication skills with a proven track record of follow-up Problem solving and research skills This position is an Office role, which requires an employee to work onsite at our Minnetonka, MN, St. Louis, MO, Madison, WI, or Omaha, NE office, on average, 3 days per week. The full salary grade for this position is $50,800 - $87,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $50,800 - $76,125. 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. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
    $50.8k-87k yearly 2d ago

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