Special Needs Plan (SNP) Program Manager

Medica • Minnetonka, MN

20h • 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. 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 and 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 combination of education and experience
• 5+ years of related experience

Nice To Haves

• Experience with Government Programs (Medicare, Medicaid, SNP)
• Experience in member/patient care coordination
• Ability to interpret and operationalize regulatory or accreditation requirements
• Strong program and project management background
• 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 but not required
• Ability to work independently and make decisions with minimal supervision
• Detail-oriented and solution-focused with advanced project management skills
• 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
• Experience with regulatory reporting

Responsibilities

• Ongoing monitoring and oversight of SNP MOC implementation, including performance evaluation based on key performance metrics
• Develop and conduct training for internal teams, external delegates, and providers participating in Medica’s SNPs
• Maintain and submit Medica’s SNP MOCs
• Prepare for and coordinate responses to audit requests
• Analyze and translate regulatory and accreditation requirements into operational processes and monitor implementation and ongoing operational compliance

Benefits

• Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 1,001-5,000 employees