Medica Health Management LLC
Clinical Services Optimization Business Analyst III
Medica Health Management LLC, Minnetonka, Minnesota, United States, 55345
Clinical Services Optimization Business Analyst III
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. This analyst will work within Medica’s Clinical Services Optimization division, specifically focused on electronic prior authorization business delivery. The analyst role is responsible to gather, research, document requirements, and maintain daily operations of ePA. This role collaborates with partners from cross-functional business areas, like network, Tech, and claims operations. Key Accountabilities Support daily delivery of ePA workflow, including process efficiency, error handling, business validation & UAT. Oversight of ePA delivery process, workflow, and execution. Including: internal and external UM. Research and speak expertly regarding the functionality of our clinical documentation system; includes providing support as the system subject matter expert within business and project teams. Cross functional Collaboration: Work cross functional with business partner to achieve program delivery. Required Qualifications Bachelor’s degree or equivalent combination of education and related work experience. 5+ years of related experience with 4+ years of experience working on large organizational projects. Skills and Abilities Implementation and new capabilities delivery experience. Computer proficiencies including Microsoft Office and experience with other. Ability to lead and be a good role model, influence change, shape and initiate work with colleagues across the organization and external. Excellent written and verbal communication skills with all levels of the organization. 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.
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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. This analyst will work within Medica’s Clinical Services Optimization division, specifically focused on electronic prior authorization business delivery. The analyst role is responsible to gather, research, document requirements, and maintain daily operations of ePA. This role collaborates with partners from cross-functional business areas, like network, Tech, and claims operations. Key Accountabilities Support daily delivery of ePA workflow, including process efficiency, error handling, business validation & UAT. Oversight of ePA delivery process, workflow, and execution. Including: internal and external UM. Research and speak expertly regarding the functionality of our clinical documentation system; includes providing support as the system subject matter expert within business and project teams. Cross functional Collaboration: Work cross functional with business partner to achieve program delivery. Required Qualifications Bachelor’s degree or equivalent combination of education and related work experience. 5+ years of related experience with 4+ years of experience working on large organizational projects. Skills and Abilities Implementation and new capabilities delivery experience. Computer proficiencies including Microsoft Office and experience with other. Ability to lead and be a good role model, influence change, shape and initiate work with colleagues across the organization and external. Excellent written and verbal communication skills with all levels of the organization. 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.
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