Manager of Provider Reimbursement

JOB REQUIREMENTS: Description Medica is a nonprofit health plan withmore than a million members that serves communities in Minnesota,Nebraska, Wisconsin, Missouri, and beyond. We deliver personalizedhealth care experiences and partner closely with providers to ensuremembers are genuinely cared for. We're a team that owns our work withaccountability, makes data-driven decisions, embraces continuouslearning, and celebrates collaboration - because success is a teamsport. It's our mission to be there in the moments that matter most forour members and employees. Join us in creating a community of connectedcare, where coordinated, quality service is the norm and every memberfeels valued. The Manager of Provider Reimbursement leads the managementof the fee schedule development, contract modeling, and implementationprocesses in provider finance. The Manager documents processes,dependencies, and tools to maintain Medica's provider fee schedules andworks with stakeholders on identifying refinement opportunities.Additionally, the Manager supports contract model data inputs,stewardship of provider finance data, and works with stakeholders toidentify opportunities to improve model functionality, efficiency, andaccuracy. The Manager coordinates projects that involve/impact multipleteams and departments. The Manager monitors unit progress toward goals,assists in department planning, and prioritization. The manager assistsin the successful operation of the provider finance department. Theincumbent ensures that processes and policies are followed to producehigh quality results. The Manager proactively engages in identifiedopportunities and facilitates solutions with various stakeholders.Performs other duties as assigned. Key Accountabilities Fee ManagementSchedule Provides fee schedule development and implementation includinguploading new fee schedules, tracking fee schedule activity, andfacilitating fee schedule provider renewal impacts and coding updatesDocuments processes, dependencies, and tools to maintain fee schedulesin Medica's provider reimbursement payment platforms Works withstakeholders to refine methods and processes in the development andimplementation of provider fee schedules management Contract Model &Data Management Supports provider contract modeling solutions andcontract modeling inputs including but not limited to Data Pac inputsWorks together with key stakeholders to optimize Medica's providernegotiation model process through the promotion of refinements toimprove model functionality, efficiency, and accuracy Promotes and leadsefforts focused on data stewardship and best practices LeadershipActivities Interacts heavily with other departments in a leadershiprole. Builds strong relationships with groups across the organization:including: Network Management, Provider Network Operations,... For fullinfo follow application link. Equal Opportunity Employer includingVeterans and Disabled Individuals APPLICATION INSTRUCTIONS:Apply Online: ipc.us/t/0AD52014E00D4E43

Created: 2026-01-15