Clinical Initiative Program Manager IV

Description

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.

This Program Manager will oversee large‑scale strategic projects within Medica’s Clinical Initiatives division, as part of Health Services’ clinical affordability work, and in alignment with Medica’s broader clinical strategy. The Program Manager is accountable for data‑driven clinical program ideation, leading in‑flight initiative planning, gathering and documenting cross‑functional business requirements, and driving forward work that supports our broader organization strategy. This role coordinates and guides cross‑functional teams – including clinical, technology, segment, and network – from design, through sizing in partnership with affordability, to implementation and program validation.

The Program Manager is responsible for partnering with stakeholders to drive strategic growth initiatives in alignment with Medica’s ambitious stewardship work. Acting as clinical initiatives subject‑matter expert, this leader is the primary liaison among Clinical Services, Affordability, other business units, and reporting teams, ensuring alignment of program objectives and successful implementation of designed solutions. Performs other duties as assigned.

• Clinical Design and Program Implementation
  • Lead clinical program implementation work on behalf of Health Services, identified through trend and by line of business
  • Drive large‑scale cross‑functional clinical business efforts across the organization
  • Partner closely with Affordability Design Consultant and other lever owner teams to build out project scope and drive execution in alignment with organizational priorities
• Affordability Support
  • Support the work to identify and drive Affordability Initiatives for Health Services, Quality, Behavioral Health, and Medical Services from ideation through implementation to achieve annual affordability target
  • Support Medical Cost Action Planning (MCAP) by managing meeting materials, closing the loop on follow‑up and creating program structure for identified work
  • Guide recommendations and facilitate decision‑making through active stakeholder engagement, ensuring that program goals and stakeholder interests are aligned
• Cross‑functional Collaboration
  • Work cross‑functionally with internal and external stakeholders to achieve program goals
  • Create and foster strong stakeholder relationships to ensure program success
  • Develop and drive Clinical and Health Services clinical strategies in alignment with broader Medica business goals

• Bachelor’s degree or equivalent experience in related clinical field – Nursing, LSW, etc.
• 8 years of related work experience beyond degree

• Clinical design thinking or prior affordability experience preferred
• Computer proficiencies including Microsoft Office (Word, Excel, Access, Outlook, Visio, One Note, Teams, etc.) and experience with other program functions (workflow, eligibility, claims, etc.)
• Ability to lead and be a good role model, 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
• Knowledge of computer applications such as Microsoft Office, Microsoft Project, Visio, Access, and familiarity with database systems
• Managing/Delegating/Measuring Work:
  Develop and assign clear, appropriate objectives, accountabilities and measures within cross‑functional work streams.…