Clinical Program Manager, Commercial Markets IV

About the role

The Clinical Program Manager-Commercial Market Division is a key contributor who communicates clinical performance to commercial customers of Medica and helps design solutions to meet the clinical and population health needs of our employer and broker customers.

Responsibilities

• Review, analyze, and communicate population performance data for employers
• Provide insights and clinical recommendations to both internal account team and external employer customers around clinical performance, performance trends, future trends/pipeline and wellness/clinical solution recommendations
• Analyze and present clinical data in partnership with commercial employer account team and enterprise analytics
• Support market strategy through clinical and financial analytics
• Develop insights into clinical performance and opportunities for a given employee population
• Participate in development of clinical strategy for larger/more strategic accounts
• Support in Matrixed environment: Responsive support for commercial accounts team, providing clinical insights from reporting, including regular cadence of review and notification of new high-cost claimants
• Serve as a resource on commercial product options for the sales and account teams
• Understand local market business dynamics and incorporate these into analysis
• Facilitate adoption of personalized employer Wellness programs
• Deep understanding of wellness and vendor programmatic options available to support employers, and also the specific details of selections and rationale for wellness options
• Consulting-like service including creating personalized wellness strategies for employers using the products available in our ecosystem
• Embassadorship of commercial market strategy around product offerings and key strategies
• Presentations: Professional presentations to current and prospective customers (including C-suite) and their brokers. Include RFPs/ finalist presentations in addition to periodic performance data

Requirements

• Bachelor’s degree in Nursing, Public Health or related clinical field; Master’s degree or MBA helpful preferred
• 7+ years of relevant work experience

Preferred Qualifications

• Clinical experience required
• Broad knowledge of managed care, the healthcare industry and health plan care management functions; knowledge of state/federal health insurance regulations beneficial, however not required
• Experience and skill in using Excel, and other BI tools like QlikSense and Power BI
• Experience in building and delivering effective presentations
• Strong analytical skills
• Experience reviewing clinical utilization and performance data for potential opportunities
• Develop and maintain knowledge of market dynamics and business strategies
• Demonstrated experience delivering results in an ambiguous and changing environment
• Demonstrated success with project management, leadership, and implementation
• Creative problem-solving skills, adaptability, and strong communication skills

Benefits

This position is an Office role, which requires an employee to work onsite at our Madison, WI office, on average, 3 days per week. The full salary grade for this position is $88,800 - $152,300. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $88,800 - $133,245. 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.