Appeals & Grievances Regulatory Analyst
About The Position
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. Oversees and implements activities to support Medica's business units and to ensure adherence with federal, state and local regulations and/or contractual requirements. Works with internal teams and/or Regulatory agencies and vendors as needed to ensure policies and procedures are compliant, requirements are communicated, and proper auditing, reporting, and/or monitoring is completed. Performs other duties as assigned.
Requirements
- Bachelor's degree or equivalent experience in related field
- 7+ years of work experience beyond degree
- 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.
Responsibilities
- Oversees and implements activities that support Medica’s business units
- Ensures adherence to federal, state, and local regulations, as well as contractual requirements
- Collaborates with internal teams, regulatory agencies, and vendors as needed
- Ensures policies and procedures remain compliant
- Communicates regulatory requirements across teams
- Conducts or oversees auditing, reporting, and monitoring activities
- Leads regulatory compliance efforts across operations
- Supports implementation of compliant processes and procedures
- Ensures alignment between business operations and regulatory expectations
Benefits
- competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services
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What This Job Offers
Job Type
Full-time
Career Level
Senior
