Senior Healthcare Analyst

Medica • Minnetonka, MN

18h • Hybrid

About The Position

Medica is a nonprofit health plan serving more than one million members in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. The Senior Healthcare Analyst serves as a strategic partner supporting health plan operations through analytics, reimbursement expertise, and cross-functional collaboration. The role transforms complex healthcare data into actionable business insights, supports payment integrity and provider reimbursement initiatives, develops scalable reporting solutions, and partners with operational leaders to improve quality, efficiency, and financial performance. The ideal candidate combines strong analytical skills with knowledge of healthcare operations, reimbursement methodologies, provider contracting, and health insurance business processes.

This is an office role requiring employees to work onsite an average of three days per week. Candidates may be located near Medica's offices in Minnetonka, Minnesota; Madison, Wisconsin; or St. Louis, Missouri. Medica does not offer work visa sponsorship. Candidates must be legally authorized to work in the United States when applying, and employment is contingent on verification of identity and work eligibility.

Requirements

• Bachelor's degree or equivalent experience in a related field.
• Five or more years of work experience beyond the degree.
• Three or more years of experience in provider reimbursement, provider network management, or provider contracting.
• Three or more years of experience with healthcare claims and payment operations.
• Knowledge of facility and professional reimbursement methodologies.
• Advanced SQL skills.
• Advanced Microsoft Excel skills.
• Strong analytical, organizational, and problem-solving skills.

Nice To Haves

• Familiarity with CMS payment rules, the Medicare Physician Fee Schedule (MPFS), Hospital Outpatient Prospective Payment System (OPPS), Inpatient Prospective Payment System (IPPS), and Ambulatory Surgery Center (ASC) payment methodologies.
• Experience with Power BI, QlikSense, or a similar business intelligence tool.
• Experience working with provider contracts and reimbursement structures, including payment methodologies for facility and professional providers.
• Strong understanding of how contractual reimbursement terms affect claims adjudication and payment accuracy.

Responsibilities

• Analyze medical, pharmacy, claims, provider, and operational datasets to identify trends, risks, and opportunities for improvement.
• Develop executive dashboards, scorecards, and KPI reporting.
• Deliver recurring and ad hoc financial analyses and reporting to support provider contracting, reimbursement, and actuarial strategies.
• Support efforts to improve the quality, transparency, and accessibility of provider payment, contract, and claims data.

Benefits

• Medical, dental, and vision benefits.
• Paid time off.
• Paid holidays.
• Paid volunteer time off.
• 401(k) contributions.
• Caregiver services.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior