Healthcare Analyst IV

Medica•Minnetonka, MN

2d•Hybrid

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. Evaluate and assess medical data to identify trends and opportunities. Determine requirements, create standards and/or define metrics to ensure complete and accurate reporting. Provide insight and recommendations using quantitative analysis and/or statistical analysis coupled with explanatory and predictive modeling to drive focused decision making.

Requirements

Bachelor's degree or equivalent experience in related field
7+ years of work experience beyond degree

Responsibilities

Lead advanced analytics to support risk adjustment forecasting, revenue estimation, and performance monitoring across applicable lines of business.
Support pricing and forecast assumptions by evaluating experience relative to benchmarks by market, product, risk segment, or provider group.
Analyze medical cost trends and utilization drivers with a specific focus on affordability levers and member impact.
Provide analytical support for pricing, rate development, and product profitability assessments incorporating risk-adjusted and benchmark-informed insights.
Ensure alignment of metrics and definitions across Actuarial, Finance, and Analytics teams.