Job Information
MEDICA HEALTH PLANS Clinical Vendor Program Manager III 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. 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. Key Accountabilities 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 decisionmaking and program oversight Facilitate complex conversations with vendors to achieve Medica\'s desired outcomes Required Qualifications Bachelor\'s degree or equivalent experience in a related field 5+ years of work... For full info follow application link. Equal Opportunity Employer including Veterans and Disabled Individuals ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/58EC297936414E50