Medica · 5 hours ago
Clinical Program Manager
Omaha, NE
Full-time
Hybrid
Mid, Senior Level
$87K/yr - $131K/yr
5+ years expMedica is a healthcare company that provides support to health system provider partners and product teams. The Clinical Program Manager will work collaboratively to design and implement strategies aimed at improving clinical outcomes and reducing unnecessary medical spending.
Health CareMedical
Responsibilities
Identify and develop clinical interventions and services that positively impact medical trend and quality
Identify interventions that improve value of care for our members including improved quality and access to appropriate care, while sustaining appropriate decreases in unnecessary medical trends
Provide insights and recommendations to care system clinical operation teams related to provider clinical operations, with the goal of improving performance in the quadruple aim
Provider partnerships include ACOs (Accountable Care Organizations), TCOC (Total Cost of Care) partnerships, Medicare Advantage, and Medicaid programs
Use clinical and financial data analysis to support strategy, tactics, and communication of results to achieve an provider partner's performance KPIs (key performance indicators)
Perform and translate data analysis to highlight care system performance and provide insights into areas of impact and improvement throughout the organization
Supports efforts to define and socialize Medica provider analytics strategies and implement analytic methods and tools in support of the strategies
Engage providers in strategic collaborative activities
Engage care system population health leaders in strategies and tactics that improve quality and access to appropriate care, including identification of both member and system level opportunities
Works with provider partners to identify transformational and innovative services that become the basis for value-based payments. Provide a forum for our partners to network and share best practices
Influence and motivate provider partner’s clinical teams identifying and implementing strategies to reduce variations in performance
Project support across all stages includes planning, communication, implementation, and evaluation of performance of projects
Supports defining and prioritizing business requirements for data requests, data validation, and clinical data analysis
Establishes annual priorities, KPIs, and targets that align with and support clinical leadership and other business units
Collaborates on annual team goals aligned with the priorities of clinical services, Medica and our provider partner care systems
Serves as an effective leader and representative of Clinical Services on various Medica committees
Fosters good communications with staff, customers and other company departments through interpersonal relationships and formal communication skills
Qualification
Required
Bachelor's degree in nursing, public health, healthcare administration or related clinical field
5+ years of work experience beyond degree within the healthcare or insurance industries with a focus on health system or client stakeholders
Preferred
Master's Degree
Strong proficiently in project management tools, including six sigma
Comfortable presenting to executive level stakeholders
Proficiency in MS office specifically MS Excel and PowerPoint
Demonstrated ability to design, evaluate, and interpret complex clinical programs, with strong problem-solving skills
Excellent written and verbal communication skills, capable of conveying complex information clearly and concisely to diverse audiences
Experience working both independently and collaboratively in cross functional teams, engaging with individuals from diverse professional backgrounds
Benefits
Competitive medical
Dental
Vision
PTO
Holidays
Paid volunteer time off
401K contributions
Caregiver services
Many other benefits to support our employees
Company
Medica
Medica is a company that provides health coverage to meet customers needs for health plan.
1001-5000 employees
H1B Sponsorship
Medica has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (2)
2024 (2)
2023 (18)
2022 (5)
2021 (2)
Funding
Current Stage
Late StageLeadership Team
John Naylor
President and CEO
Jeni Alm
Vice President, Provider Partnerships and Solutions
Recent News
Insurance News in the United States
2025-12-13
Star Tribune
2025-11-24
2025-11-18
Company data provided by crunchbase