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MEDICA HEALTH PLANS Clinical Program Manager ePA in MADISON, Wisconsin

JOB REQUIREMENTS: 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 initiatives within Medica\'s Clinical Services Optimization division, with a primary focus on the electronic prior authorization (ePA) business delivery. The Program Manager is accountable for leading program planning, gathering and documenting business requirements, ensuring seamless daily operations of ePA, and driving process improvements. This role coordinates and guides cross-functional teams-including network, Technology, and claims operations-from concept and requirements through delivery, ongoing maintenance, and validation. The Program Manager is responsible for operationalizing regulatory and business requirements to support both compliance and strategic growth initiatives. Serving as the ePA clinical documentation system subject matter expert, this leader acts as the primary liaison among Clinical Services, other business units, Medica IT, clinical platform vendors, and reporting teams, ensuring alignment of program objectives and successful implementation of solutions. Performs other duties as assigned. Key Accountabilities Program Manager for ePA delivery Lead Delivery and Optimization of ePA Workflow Drive process efficiency and oversee the management of error handling within the electronic prior authorization (ePA) workflow Lead business validation activities and user acceptance testing (UAT) to ensure that system solutions meet organizational needs and requirements Assess and ensure that all systems and procedures are operating as designed, maintaining high standards for operational reliability and effectiveness Evaluate requests for changes to the system, determining feasibility and implications for business operations Develop actionable recommendations to address business system and reporting issues, ensuring continuous improvement and alignment with program objectives Implement automation and standardized practices to reduce manual processes, eliminate duplication, and enhance overall operational efficiency Expert Oversight of Clinical Documentation System as it relates to cross functional ePA delivery Research system functionality and provide subject matter expertise to business and project... For full info follow application link. Equal Opportunity Employer including Veterans and Disabled Individuals ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/F66A33607BEA4512

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