Clinical Vendor Program Manager III

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 Program Manager role is responsible for oversight, operational execution, and continuous improvement of Care Management vendors that support high quality, member-centered care. This role works cross-functionally by coordinating closely with both external vendor partners and internal operational, clinical, and technical teams to ensure compliance with contractual obligations, regulatory requirements, and organizational standards. The Program Manager serves as the primary liaison between the organization and the vendor driving performance, quality, and program success to meet and support Medica's mission, vision and desired outcomes.

Performs other duties as assigned.

• Vendor Oversight & Compliance
  • Oversee day-to-day operational performance of care management workflows and serve as the primary point of contact for the vendor.
  • Facilitate structured, recurring vendor meetings to review performance, address issues, and align on priorities.
  • Monitor vendor performance against contractual obligations, KPIs, and service-level agreements (SLAs).
  • Ensure program adherence to regulatory requirements and lead readiness and response efforts for audits and reviews.
  • Maintain program outcome data and conduct regular analysis of performance and member engagement metrics to identify trends and opportunities for improvement.
• Program Management, Collaboration & Communication
  • Manage cross-functional relationships including but not limited to:
    Analytics, Product Leaders, IT, Sourcing and Finance.
  • Conduct quarterly and annual vendor performance reviews, identifying strengths, gaps, and needed corrective actions.
  • Partner with business analyst and analytics teams to optimize care management dashboard and reporting tools.
  • Review and reconcile all program invoices, ensuring accuracy and adherence to spend.
  • Communicate ongoing vendor performance results, risk assessments, and mitigation strategies to stakeholders to support informed decision making and program oversight.
  • Facilitate complex conversations with vendors to achieve Medica's desired outcomes.

• Bachelor's degree or equivalent experience in a related field.
• 5+ years of work experience beyond degree.

• Experience in NCQA, specifically PHM standards preferred.
• Proficiency with Microsoft Office applications, including Word, Excel, Outlook, and One Note, as well as the ability to learn and utilize additional software tools.
• Demonstrates sound judgement in navigating vendor communications, ensuring appropriate transparency while protecting organizational interests.
• Uses critical thinking and clinical context when identifying issues within workflows, documentation, or member care processes.
• Strong ability to manage multiple vendors in parallel while adhering to operational priorities.
• Excellent written and verbal communication skills, with the ability to interact professionally across all levels of the organization.
• Experience setting expectations and providing direction to support team performance, accountability, and operational excellence.

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…