Clinical Program Manager ePA

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. This Program Manager will oversee initiatives withinMedica's Clinical Services Optimization division, with a primary focuson the electronic prior authorization (ePA) business delivery. TheProgram Manager is accountable for leading program planning, gatheringand documenting business requirements, ensuring seamless dailyoperations of ePA, and driving process improvements. This rolecoordinates and guides cross-functional teams-including network,Technology, and claims operations-from concept and requirements throughdelivery, ongoing maintenance, and validation. The Program Manager isresponsible for operationalizing regulatory and business requirements tosupport both compliance and strategic growth initiatives. Serving as theePA clinical documentation system subject matter expert, this leaderacts as the primary liaison among Clinical Services, other businessunits, Medica IT, clinical platform vendors, and reporting teams,ensuring alignment of program objectives and successful implementationof solutions. Performs other duties as assigned. Key AccountabilitiesProgram Manager for ePA delivery Lead Delivery and Optimization of ePAWorkflow Drive process efficiency and oversee the management of errorhandling within the electronic prior authorization (ePA) workflow Leadbusiness validation activities and user acceptance testing (UAT) toensure that system solutions meet organizational needs and requirementsAssess and ensure that all systems and procedures are operating asdesigned, maintaining high standards for operational reliability andeffectiveness Evaluate requests for changes to the system, determiningfeasibility and implications for business operations Develop actionablerecommendations to address business system and reporting issues,ensuring continuous improvement and alignment with program objectivesImplement automation and standardized practices to reduce manualprocesses, eliminate duplication, and enhance overall operationalefficiency Expert Oversight of Clinical Documentation System as itrelates to cross functional ePA delivery Research system functionalityand provide subject matter expertise to business and project... Forfull info follow application link. Equal Opportunity Employer includingVeterans and Disabled Individuals APPLICATION INSTRUCTIONS:Apply Online: ipc.us/t/F66A33607BEA4512

Created: 2026-02-26