Provider Network Strategy Manager

Medica; Hopkins (MN); On-site; USD 89,000 - 152,000; Full time

Job summary

Medica in Minnesota is seeking a Manager, Provider Network Solutions to lead development, implementation, and oversight of provider network strategies and regulatory deliverables. This role manages teams focused on network analysis, NCQA HPA, data integrity, and multi-state initiatives to meet CMS and state requirements while supporting growth and market objectives.

The position partners with business leaders, Regulatory Affairs, and vendors to ensure networks meet accreditation standards and

Qualifications

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

Responsibilities

• Lead provider network strategy and operations to support growth and access objectives
• Oversee data integrity, regulatory reporting, and NCQA/HPA deliverables
• Collaborate with leadership and vendors to ensure regulatory compliance and performance metrics
• Guide cross-functional initiatives and continuous improvement in provider network programs

Skills

Advanced data query skills

Leadership experience

Quest Analytics

QHP/CMS Network Adequacy

Education

Bachelor's degree or equivalent in related field

5+ years of work experience beyond degree

Job description

Medica in Minnesota is seeking a Manager, Provider Network Solutions to lead development, implementation, and oversight of provider network strategies and regulatory deliverables. This role manages teams focused on network analysis, NCQA HPA, data integrity, and multi-state initiatives to meet CMS and state requirements while supporting growth and market objectives.

The position partners with business leaders, Regulatory Affairs, and vendors to ensure networks meet accreditation standards and