Provider Network Strategy & Compliance Manager

Medica; Madison (WI); On-site; USD 89,000 - 133,000; Full time

Job summary

Medica is a nonprofit health plan serving members across multiple states, including Wisconsin. The Manager, Provider Network Solutions leads the development, implementation, and oversight of provider network strategies to ensure growth, access, and regulatory compliance.

The role partners with stakeholders and vendors to execute complex network initiatives and deliver results. As a people leader, you will guide teams, drive process improvements, and ensure effective execution of provider network

Qualifications

• Bachelor's degree or equivalent in related field.
• 5+ years of work experience beyond degree.
• Advanced data query skills and experience.

Responsibilities

• Leads provider network strategy and operations to support growth, regulatory compliance, and access objectives.
• Oversees network planning, data integrity, and performance metrics for regulatory reporting.
• Drives cross-functional initiatives, vendor partnerships, and continuous process improvements.
• Mentors teams and ensures adherence to policies, training, and documentation.

Skills

Advanced data query skills

Education

Bachelor's degree or equivalent in related field

5+ years of work experience beyond degree

Job description

Medica is a nonprofit health plan serving members across multiple states, including Wisconsin. The Manager, Provider Network Solutions leads the development, implementation, and oversight of provider network strategies to ensure growth, access, and regulatory compliance.

The role partners with stakeholders and vendors to execute complex network initiatives and deliver results. As a people leader, you will guide teams, drive process improvements, and ensure effective execution of provider network