Clinical Vendor Program Manager IV

Clinical Vendor Program Manager IV

Medica is a nonprofit health plan with more than a million members serving 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.

Responsible for vendor oversight and delivery of a delegated Utilization Management program. Works closely with the Clinical Vendor Oversight Manager to ensure compliance with contractual obligations, regulatory requirements, and organizational standards.

• Vendor Oversight and Compliance
  • Act as the main point of contact for the vendor relationship to support a delegated clinical program and affordability initiative.
  • Vendor Performance & Accountability
    • Monitor vendor adherence to contractual terms, maintain service level agreement (SLA) documentation and budget management.
    • Identify opportunities and implement corrective action plans when necessary.
  • Partner with Clinical Regulatory Oversight Program Manager to maintain regulatory compliance.
  • Ensure timely submission of reports and deliverables as outlined in Statements of Work (SOW).
• Program Management, Collaboration & Communication
  • Manage cross‑functional relationships: IT & Business Partners – Provider Network, Internal Utilization Management, Provider Data & Eligibility Teams, Claims, Customer Service, and Account Management.
  • Oversee affordability measures and outcome monitoring.
  • Drive regular meetings with vendors and internal stakeholders.
  • Facilitate complex conversations with vendors to achieve Medica’s desired outcomes.
  • Provide updates to leadership on vendor performance, risks, and mitigation strategies.

• Bachelor’s degree or equivalent experience in a related field.
• 7+ years of related experience beyond the degree.

• Experience in vendor management and clinical delegated vendor oversight strongly preferred.
• Computer proficiencies including Microsoft Office (Word, Excel, Access, Outlook, Visio, One Note) and experience with other relevant tools.
• Knowledge of program functions (workflow, eligibility, claims, etc.).
• Ability to lead, influence change, shape and initiate work with colleagues across the organization and external partners (care systems, community collaborations, vendors) to achieve department goals.
• Excellent written and verbal communication skills with all levels of the organization.
• Ability to develop objectives, accountabilities, and measures; monitor progress; identify and address barriers.
• Commitment to continuous quality improvement; skilled user of quality tools and techniques.
• Experience setting expectations and direction for team delivery.

This is an office role requiring on‑site presence about three days per week. Candidates located near Minnetonka, MN or Madison, WI are preferred.

The salary grade for this position is $88,800 – $152,300, with the typical hiring range $88,800 – $133,245. Medica offers a generous total rewards package including competitive medical, dental, vision, PTO, holidays, paid volunteer time off, 401(k) contributions, caregiver services, and more.

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.

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