Clinical Initatives Business Analyst

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.

We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.

The Clinical Initiatives Business Analyst will support enterprise clinical performance, regulatory and compliance requirements by developing actionable reporting, analyzing performance trends, and translating data into operational insights. This role partners closely with clinical operations, population health, behavioral health, and quality teams to ensure data-driven decision-making that advances clinical outcomes, regulatory compliance, and strategic initiatives.

The ideal candidate is skilled in healthcare data analysis, experienced with clinical measures (utilization and care management, managed care performance metrics and quality data,), and comfortable working with both technical and non-technical stakeholders. Perform other duties as assigned.

Key Accountabilities

• Build, maintain, and enhance clinical and operational dashboards (e.g., utilization, care management performance)
• Develop recurring and ad hoc reports using SQL, Excel, BI tools (Power BI, Tableau, or similar).
• Translate clinical data into actionable insights for leadership and frontline teams.
• Validate data accuracy, completeness, and integrity. Serve as a subject matter resource to team members and stakeholders within area of expertise

Stakeholder Collaboration

• Partner with clinical leadership to define reporting needs and KPIs.
• Work with IT, data engineering, and analytics teams to refine data sources and improve data accessibility.
• Present findings to stakeholders in a clear, concise, and compelling manner.

Regulatory & Compliance Support

• Assist with reporting requirements for state and federal regulators, including MHPAEA, NCQA, and CMS (as applicable).
• Support development of metrics and analyses used for audits, accreditation, and quality programs.

Continuous Improvement

• Automate manual reporting processes and develop scalable reporting structures.
• Contribute to analytics standards, documentation, and reporting governance.

Required Qualifications

• Bachelor's degree or equivalent experience in a related field
• 5 years of experience in healthcare analytics, clinical reporting, or business analysis.

Preferred Qualifications

• Experience supporting clinical, regulatory, or operational initiatives within healthcare or health services
• Experience leading or contributing to complex, cross functional initiatives or projects

Skills and Abilities:

• Bachelor's degree in public health, data analytics, health informatics, business, or related field (or equivalent experience).
• Proficiency in SQL, Excel, and BI tools (Power BI, Tableau, Qlik).
• Experience working with healthcare datasets (claims, utilization management/prior auth, care management, quality measures).
• Strong understanding of clinical workflows, utilization management, and/or population health.
• Ability to translate complex data into understandable insights for non-technical audiences.
• Excellent problem-solving, communication, and stakeholder management 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 $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…