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.
The Delegate Improvement Analyst III leads complex analytical efforts that
support oversight, performance improvement, and regulatory compliance across
delegated entities and internal teams. This role designs and delivers metrics,
reports, and analyses that inform business decisions and drive improvements in
quality, operational performance, and regulatory adherence. It works closely
with DHS and CMS during audits and collaborates with internal departments to
ensure accurate, integrated reporting and response readiness. Operating with
minimal supervision, the Analyst III applies advanced analytical judgment,
serves as a resource to others, and contributes strategically to delegate
oversight and improvement initiatives. Performs other duties as assigned.
Key Accountabilities
Lead Development of Metrics, Reporting, & Analytical Insight
Design and maintain performance metrics that evaluate delegate outcomes and
compliance.
Develop reports and analyses that translate complex data into actionable
insights.
Identify trends, risks, and improvement opportunities across delegated
programs.
Communicate findings clearly to support informed decision-making.
Support Delegate Oversight & Improvement Initiative
Complete comprehensive audits based on state and federal regulatory
requirements.
Analyze delegate performance against contractual, regulatory, and quality
standards.
Partner with internal teams to identify gaps and recommend improvement
strategies.
Monitor progress of corrective actions and validate sustained improvement.
Document findings and outcomes to support consistent oversight.
Coordinate DHS & CMS Audit Support Activities
Support preparation for DHS and CMS site audits through data validation and
reporting.
Collaborate with delegates and internal stakeholders to gather required
documentation.
Respond to audit requests with accurate, timely, and defensible
information.
Track audit findings and support resolution and follow-up activities.
Drive Cross-Functional Data Integration & Collaboration
Partner with clinical, operational, compliance, and analytics teams to
align information.
Ensure data consistency across reports, submissions, and oversight tools.
Address discrepancies through root-cause analysis and coordination.
Promote shared understanding of delegate performance across the
organization.
Serve as an Analytical Resource & Contribute to Process Improvement
Provide guidance to peers on metrics interpretation, reporting standards,
and analysis methods.
Identify opportunities to improve analytical tools, workflows, or oversight
processes.
Recommend enhancements that strengthen accuracy, efficiency, and usability.
Share best practices that advance delegate improvement and analytical
maturity.
Required Qualifications
Bachelor's degree in Nursing, Social Work, Healthcare Administration or
related degree and / or equivalent work experience in related field
5+ years of work experience beyond degree
Preferred Qualifications
Experience with care coordination, care or case management, and working with
government programs strongly preferred
Audit experience
Experience and knowledge of Medicaid and SNP products
Project management or program management experience
Microsoft Office proficiency, including Word, PowerPoint and Excel
This position is a Remote role. To be eligible for consideration, candidates
must have a primary home address located within any state where Medica is
registered as an employer - AR, AZ, FL, GA, IA, IL, KS, KY, MI, MN, MO, ND, NE,
OK, SD, TN, TX, VA, WI
The full salary grade for this position is $70,200 - $120,400. While the full
salary grade is provided, the typical hiring salary range for this role is
expected to be between $70,200 - $120,400. 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.
Eligibility to work in the US: Medica does not offer work visa sponsorship for
this role. All candidates must be legally authorized to work in the United
States at the time of application. Employment is contingent on verification of
identity and eligibility to work in the United States.
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.