Value Based Program Manager

Medica's Value Based Program Manager is a key contributor to successful performance of value-based contracts and networks including Medica's Accountable Care Organizations (ACO). This position is responsible for supporting and maintaining the clinical relationship with Medica's provider partners, working to identify and implement clinical interventions to improve outcomes and quality of care, decrease unnecessary medical spend, and improve care efficiency.

Key Accountabilities Include:

• Identify and develop clinical interventions and services that positively impact medical trend and quality
• Use clinical and financial data analysis to support strategy, tactics, and communication of results to achieve an ACO (Accountable Care Organizations) provider partner's value-based performance KPIs (key performance indicators)
• Perform and translate data analysis to highlight care system performance and provide insights into areas of impact and improvement throughout the organization
• Analyze clinical and financial data to help make tactics and strategies supporting value based care performance
• Engage providers in strategic collaborative activities
• Support Overall Clinical Value Strategy

The incumbent works in close collaboration with Medica's Clinical Services, Network Management, and Analytics departments and requires understanding of managed care business practices, provider delivery governance, internal and external operations, design thinking, and the development and use of actionable analytics. Strong relationship management skills are critical for this role as is the ability to manage complex clinical projects using established project management tools and methodologies.

Qualifications:

• Bachelor's degree in Nursing, Public Health, or related field; Master's degree preferred
• 7+ years of related work experience
• Broad knowledge of managed care, the healthcare industry and health plan care management functions required; knowledge of state/federal health insurance regulations preferred
• Demonstrated experience in change management, including leading multiple change initiatives simultaneously
• Experience in new clinical product development, project management, and quality of process improvement
• Demonstrated experience delivering results in an ambiguous and changing environment
• Demonstrated success with project management, leadership, and implementation; PMP certification beneficial, however not required
• Creative problem-solving skills, adaptability, and strong communication skills

This position is a Hub role, which requires an employee to occasionally come onsite to the designated office - Minnetonka - for applicable heads-up work. Frequency is determined by business need as decided by leadership.

Medica's commitment to diversity, equity and inclusion (DEI) includes unifying our workforce through learning and development, recruitment and retention. We consistently communicate the importance of DEI, celebrate achievements, and seek out community partnerships and diverse suppliers that are representative of everyone in our community. We are developing sustainable programs and investing time, talent and resources to ensure that we are living our values. We are an Equal Opportunity/Affirmative Action 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

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)