Reimbursement Policy Analyst III

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. Responsible for Medica's Reimbursement Policies,including annual maintenance, implementation, research, drafting andpresenting policy recommendations for committee vote and coordination ofclaims system changes to support claim payment accuracy. Performs otherduties as assigned. Key Accountabilities Collaborate closely withnetwork management and configuration to troubleshoot claims issues andupdate systems to resolve complex issues Present insights andrecommendations in a way that enables leaders to make confident,data-informed decisions Serve as subject matter expert in reimbursementpolicy for all lines of business Required Qualifications Bachelor'sdegree or equivalent experience in a related field 5+ years of workexperience beyond degree Preferred Qualifications Advanced Excel skillsCoding certification strongly preferred: CPC, CPC-P, COC, RHIT, CSS(preferred someone credentialed in facility coding) Function as an SMEfor reimbursement policies Able to analyze and translate data (todetermine financial impact) and develop recommendations Ability toprepare and develop diverse information into effective presentationsExperience leading/facilitating process improvement teams This positionis an Office role, which requires an employee to work onsite, onaverage, 3 days per week. We are open to candidates located near one ofthe following office locations: Minnetonka, MN, Madison, WI, Omaha, NE,or St. Louis, MO. The full salary grade for this position is $62,700 -$107,500. While the full salary grade is provided, the typical hiringsalary range for this role is expected to be between $62,700 -$94,080. Annual salary range placement will depend on a variety offactors including, but not limited to, education, work experience,applicable certifications and/or licensure, the position's scope andresponsibility, internal pay equity and external market salary data. Inaddition to compensation, Medica offers a generous total rewards packagethat includes competitive medical, dental, vision, PTO, Holidays, paidvolunteer time off, 401K contributions, caregiver services and manyother benefits to support our employees. The... For full info followapplication link. Equal Opportunity Employer including Veterans andDisabled Individuals APPLICATION INSTRUCTIONS: Apply Online:ipc.us/t/B835CB2249AF45E3

Created: 2026-03-23