Special Needs Plan (SNP) Program Manager
Medica•Minnetonka, MN
•Hybrid
About The Position
Medica’s Special Needs Plan (SNP) Program Manager is responsible for providing a high level of program management and product-specific expertise to ensure program and product performance, quality, regulatory adherence, and Centers for Medicare & Medicaid Services (CMS) audit readiness. Our Program Manager carefully monitors performance and compliance with CMS regulatory requirements and Medica’s approved Models of Care (MOCs). Leads projects for implementation of program enhancements as well as changes based on regulatory updates. Performs other duties as assigned.
Requirements
- Bachelor's degree or equivalent experience in related field
- 5+ years of related work experience beyond degree
- Ability to work independently and make decisions with minimal supervision
- Detail-oriented and solution-focused
- Proficiency in Microsoft Word, PowerPoint, and Excel
- Strong analytical skills with the ability to synthesize information and recommend actions
- Excellent collaboration and influencing skills to drive contributions from non-direct reports
- Exceptional written and verbal communication skills for internal and external stakeholders
- 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.
Nice To Haves
- 2+ years care coordination experience
- Experience with Government Programs (Medicare, Medicaid, SNP)
- Ability to interpret and operationalize regulatory or accreditation requirements
- Strong program and project management skills
- Experience developing training resources and delivering presentations
- Experience working with external regulators and managing audit requests
- Clinical experience as an RN, LPN, or social worker (LSW or equivalent) preferred
- Experience with regulatory reporting
Responsibilities
- Assist with maintenance and submission of Medica’s SNP MOCs
- Ongoing monitoring and oversight of SNP MOC implementation, including performance evaluation based on key metrics
- Develop and conduct training for internal teams, external delegates, and providers participating in Medica’s SNPs
- Prepare for and coordinate responses to audit requests
- Perform audits of care coordination activities to ensure compliance with CMS and State requirements
- Analyze and translate regulatory requirements into operational processes and monitor implementation and ongoing operational compliance
Benefits
- competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Upload and Match Resume
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
