Program Manager III (Clinical Regulatory Oversight)

The Program Manager (Clinical Regulatory Oversight) is responsible for all aspects of the development and implementation of assigned projects and or initiatives and provides a single point of contact for those projects. Provides subject matter expertise based on established project management techniques. The Program Manager is responsible for ensuring clinical services meets all regulatory requirements for delivery in Care Management and Utilization Management. This includes, but is not limited to UM departmental policies, ensuring accurate system configuration, and reviewing and implementing any updates coming from Medica's Compliance team accordingly.

Qualifications

• Bachelor's degree or equivalent experience in related field, plus 5 years of related work experience beyond degree
• Experience in the operational delivery of Medical Management: Case Management, Utilization Management, and Appeals & Grievances
• Experience in applying regulatory requirements to Health Plan Medical Management operations
  
  

Skills And Abilities

• Ability to bring cross-functional alignment to execution of a program
• Ability to work and make decisions autonomously and with limited supervision
• Exceptional organizational skills with ability to juggle many tasks without losing sight of key priorities and business strategies - Self-motivated, results driven
• Successful relationship builder with ability to manage and nurture stakeholder relationships in a matrix environment
• Excellent communication skills both written and verbal
  
  

This position is a Remote role. The employee must be located in any state in which Medica is an employer and will work remotely 100% of the time.

The full salary range for this position is $85,000 - $145,700. 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.

Medica's commitment to diversity, equity and inclusion (DEI) includes unifying our workforce through learning and development, recruitment and retention. We consistently communicate the importance of DEI, celebrate achievements, and seek out community partnerships and diverse suppliers that are representative of everyone in our community. We are developing sustainable programs and investing time, talent and resources to ensure that we are living our values. We are an Equal Opportunity/Affirmative Action 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.