Talent.com
Clinical Program Manager
Clinical Program ManagerMedica • Minnetonka, MN, United States
Clinical Program Manager

Clinical Program Manager

Medica • Minnetonka, MN, United States
[job_card.30_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

Description

The Clinical Program Manager provides support to health system provider partners as well as Medica's product and segment teams. The Clinical Program Manager will work collaboratively with leadership and cross-functional partners to design and develop actionable strategies to address health system specific clinical cost and utilization opportunities.

This position is responsible for supporting and maintaining the clinical relationship with Medica's provider partners, working to identify and implement clinical interventions to improve outcomes and quality of care, decrease unnecessary medical spend, and improve care efficiency. The incumbent works in close collaboration with Medica's clinical services, network management, and analytics departments. This position requires understanding of managed care business practices, provider delivery governance, internal and external operations, design thinking, and the development and use of actionable analytics. Strong relationship management skills are critical for this role as is the ability to manage complex clinical projects using established project management tools and methodologies. Performs other duties as assigned.

Key Accountabilities

Identify and develop clinical interventions and services that positively impact medical trend and quality

  • Identify interventions that improve value of care for our members including improved quality and access to appropriate care, while sustaining appropriate decreases in unnecessary medical trends.

Provide insights and recommendations to care system clinical operation teams related to provider clinical operations, with the goal of improving performance in the quadruple aim.

  • Provider partnerships include ACOs (Accountable Care Organizations), TCOC (Total Cost of Care) partnerships, Medicare Advantage, and Medicaid programs
  • Use clinical and financial data analysis to support strategy, tactics, and communication of results to achieve an provider partner's performance KPIs (key performance indicators).
  • Perform and translate data analysis to highlight care system performance and provide insights into areas of impact and improvement throughout the organization.

  • Supports efforts to define and socialize Medica provider analytics strategies and implement analytic methods and tools in support of the strategies.
  • Engage providers in strategic collaborative activities

  • Engage care system population health leaders in strategies and tactics that improve quality and access to appropriate care, including identification of both member and system level opportunities.
  • Works with provider partners to identify transformational and innovative services that become the basis for value-based payments. Provide a forum for our partners to network and share best practices.
  • Influence and motivate provider partner's clinical teams identifying and implementing strategies to reduce variations in performance.
  • Project support across all stages includes planning, communication, implementation, and evaluation of performance of projects
  • Support Overall Clinical Value Strategy

  • Supports defining and prioritizing business requirements for data requests, data validation, and clinical data analysis.
  • Establishes annual priorities, KPIs, and targets that align with and support clinical leadership and other business units.
  • Collaborates on annual team goals aligned with the priorities of clinical services, Medica and our provider partner care systems.
  • Serves as an effective leader and representative of Clinical Services on various Medica committees.
  • Fosters good communications with staff, customers and other company departments through interpersonal relationships and formal communication skills.
  • Required Qualifications

  • Bachelor's degree in nursing, public health, healthcare administration or related clinical field
  • 5+ years of work experience beyond degree within the healthcare or insurance industries with a focus on health system or client stakeholders
  • Preferred Qualifications

  • Master's Degree
  • Strong proficiently in project management tools, including six sigma
  • Comfortable presenting to executive level stakeholders
  • Proficiency in MS office specifically MS Excel and PowerPoint
  • Demonstrated ability to design, evaluate, and interpret complex clinical programs, with strong problem-solving skills.
  • Excellent written and verbal communication skills, capable of conveying complex information clearly and concisely to diverse audiences.
  • Experience working both independently and collaboratively in cross functional teams, engaging with individuals from diverse professional backgrounds.
  • Skills and Abilities

  • Demonstrated capability to present key findings effectively to a non-technical audience both written and verbal
  • Experience working with claim / employer group data, including John Hopkins ACG Grouper, Milliman HCG Grouper
  • Demonstrated problem solving skills
  • An internal drive to understand root cause and an inherent curiosity to problem solve
  • Ability to function in a fast-paced, dynamic culture is important for success in this role
  • 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, Omaha, NE, or St. Louis, MO.

    The full salary grade for this position is $87,100 - $149,300. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $87,100 - $130,620. 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.

    We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

    Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities

    This employer is required to notify all applicants of their rights pursuant to federal employment laws.

    For further information, please review the Know Your Rights notice from the Department of Labor.

    [job_alerts.create_a_job]

    Clinical Program Manager • Minnetonka, MN, United States

    [internal_linking.related_jobs]
    RN Clinical Manager

    RN Clinical Manager

    CenterWell Primary Care • Brooklyn Park, MN, United States
    [job_card.full_time]
    Become a part of our caring community and help us put health first.This is not a remote or work-from-home position.This position requires you to sit on-site at our. This role is a focused on both ho...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Travel Physical Therapist (PT) - $2,622 per week in Anoka, MN

    Travel Physical Therapist (PT) - $2,622 per week in Anoka, MN

    Triage Staffing LLC • Anoka, MN, US
    [job_card.full_time]
    Travel Rehab : Physical Therapy Anoka.Shift Details : 8H Days (12 : 00 AM-12 : 00 PM).Length : 13 WEEKS 13 weeks.Apply for specific facility details.[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Clinical Program Manager

    Clinical Program Manager

    Medica • Minnetonka, MN, US
    [job_card.full_time]
    The Clinical Program Manager provides support to health system provider partners as well as Medica's product and segment teams. The Clinical Program Manager will work collaboratively with leadership...[show_more]
    [last_updated.last_updated_30] • [promoted]
    HeartMetrics Sr Program Manager

    HeartMetrics Sr Program Manager

    Medtronic • Mounds View, Minnesota, USA
    [job_card.full_time]
    We anticipate the application window for this opening will close on - 10 Dec 2025.At Medtronic you can begin a life-long career of exploration and innovation while helping champion healthcare acces...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Direct Support Program Supervisor

    Direct Support Program Supervisor

    Sevita • Coon Rapids, MN, US
    [job_card.full_time] +1
    Sevita family, provides community-based services for individuals with intellectual and developmental disabilities.Here we believe every person has the right to live well, and everyone deserves to h...[show_more]
    [last_updated.last_updated_30] • [promoted]
    RN Clinical Manager

    RN Clinical Manager

    CenterWell • Minneapolis, MN, United States
    [job_card.full_time]
    Become a part of our caring community and help us put health first.This is not a remote or work-from-home position.This position requires you to sit on-site at our. This role is a focused on both ho...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Senior Program Manager - Medical Devices

    Senior Program Manager - Medical Devices

    Freudenberg • Minnetonka, MN, US
    [job_card.full_time]
    Working at Freudenberg : We will wow your world!.Provide leadership, goal-setting, communications, and facilitation skills to guide and motivate project personnel in a matrixed environment.Lead proj...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Principal Program Manager

    Principal Program Manager

    TEKsystems • Minneapolis, MN, United States
    [job_card.full_time]
    A client of TEKsystems is working through a large enterprise transformation.They require a strong Program Manager to help them implement and integrate Salesforce Health Cloud into there ecosystem.S...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Clinical Trial Manager

    Clinical Trial Manager

    bostonscientific • Maple Grove, Minnesota, USA
    [job_card.full_time]
    Diversity - Innovation - Caring - Global Collaboration - Winning Spirit- High Performance.At Boston Scientific well give you the opportunity to harness all thats within you by working in teams of d...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Senior Program Manager (Medical Device)

    Senior Program Manager (Medical Device)

    LCI-Lawinger Consulting • Fridley, MN, US
    [job_card.full_time]
    [filters_job_card.quick_apply]
    Program Manager is responsible for planning, managing, and executing complex, multi-device product development projects in alignment with applicable standard operating procedures.This role leads cr...[show_more]
    [last_updated.last_updated_variable_days]
    Clinical Quality Manager

    Clinical Quality Manager

    Minnesota Staffing • Minnetonka, MN, US
    [job_card.full_time]
    Electrophysiologists and cardiothoracic surgeons around the globe use AtriCure technologies for the treatment of Afib and reduction of Afib related complications. AtriCure's Isolator Synergy Ablatio...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Clinical Trial Manager

    Clinical Trial Manager

    ICON • Minneapolis, MN, US
    [job_card.full_time]
    Clinical Trial Manager (Diabetes) - Canada.ICON plc is a world-leading healthcare intelligence and clinical research organization. We're proud to foster an inclusive environment driving innovation a...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Clinical Project Manager

    Clinical Project Manager

    GForce Life Sciences • Maple Grove, MN, US
    [job_card.temporary]
    Our client, a Fortune 500 medical device company, has engaged GForce Life Sciences to provide a Clinical Project Manager who will report directly to the Senior Manager, Project Management.The Clini...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Travel Behavioral Health Tech - $20 to $26 per hour in Lakeville, MN

    Travel Behavioral Health Tech - $20 to $26 per hour in Lakeville, MN

    AlliedTravelCareers • Lakeville, MN, US
    [job_card.full_time]
    AlliedTravelCareers is working with All Medical Personnel to find a qualified Behavioral Health Tech in Lakeville, Minnesota, 55044!. Specialty : Paraprofessional - Behavioral Health.Attends work on ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    RN Clinical Manager

    RN Clinical Manager

    Centerwell • Minneapolis, MN, US
    [job_card.full_time]
    The RN Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel.This role is focused on both home health clinical quality assurance and home health ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Sr Technical Program Manager

    Sr Technical Program Manager

    Chewy • Minneapolis, Minnesota, USA
    [job_card.full_time]
    Chewy is looking for an experienced.Customer Care Data to join our Customer Care Solutions team! As the TPM youll orchestrate complex cross-functional programs that turn data into measurable busine...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Managing Veterinarian / Medical Director

    Managing Veterinarian / Medical Director

    National Veterinary Associates • ISANTI, Minnesota, United States
    [job_card.permanent]
    Lead, Mentor, and Grow with Us.Francis Veterinary Clinic | Isanti, MN.Francis Veterinary Clinic is growing fast, and we’re ready to welcome a. If you’re an experienced DVM ready to step into leaders...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Remote FP&A Manager – AI Trainer ($50-$60 / hour)

    Remote FP&A Manager – AI Trainer ($50-$60 / hour)

    Data Annotation • Coon Rapids, Minnesota
    [filters.remote]
    [job_card.full_time] +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...[show_more]
    [last_updated.last_updated_30] • [promoted]