Provider Quality & Performance Manager

Medica; Madison (WI); On-site; USD 70,000 - 105,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

PTO

Job summary

Medica is a nonprofit health plan serving members across Minnesota, Nebraska, Wisconsin, Missouri, and beyond. The Provider Quality Program Manager II will coordinate provider quality initiatives, support Medicare Stars/HEDIS and value-based care programs, and partner with Quality, Clinical Provider Partnerships, and Network Management to drive performance improvements.

The role requires leading data-driven analyses, preparing performance reports, and collaborating with internal and external

Qualifications

• Bachelor's degree or equivalent experience in related field.
• 5+ years of work experience beyond degree in healthcare quality, provider relations, population health, health plan operations, value-based care, program management, or related healthcare field.

Responsibilities

• Coordinate implementation and ongoing management of provider quality initiatives across assigned provider groups and lines of business.
• Support quality improvement strategies focused on Medicare Stars, Medicaid quality measures, HEDIS, and value-based care programs.
• Monitor program milestones, deliverables, and outcomes to ensure achievement of goals.
• Provide program management support for cross-functional quality improvement efforts.

Skills

Project management

Stakeholder management

Data interpretation

Communication

Education

Bachelor's degree or equivalent

Tools

Microsoft Office

Healthcare reporting tools

Job description

Medica is a nonprofit health plan serving members across Minnesota, Nebraska, Wisconsin, Missouri, and beyond. The Provider Quality Program Manager II will coordinate provider quality initiatives, support Medicare Stars/HEDIS and value-based care programs, and partner with Quality, Clinical Provider Partnerships, and Network Management to drive performance improvements.

The role requires leading data-driven analyses, preparing performance reports, and collaborating with internal and external