Delegate Improvement Auditor / Analyst

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.  

The Delegate Improvement Analyst III leads complex analytical efforts that support oversight, performance improvement, and regulatory compliance across delegated entities and internal teams. This role designs and delivers metrics, reports, and analyses that inform business decisions and drive improvements in quality, operational performance, and regulatory adherence. It works closely with DHS and CMS during audits and collaborates with internal departments to ensure accurate, integrated reporting and response readiness. Operating with minimal supervision, the Analyst III applies advanced analytical judgment, serves as a resource to others, and contributes strategically to delegate oversight and improvement initiatives. Performs other duties as assigned. 

Key Accountabilities 

• Lead Development of Metrics, Reporting, & Analytical Insight
  • Design and maintain performance metrics that evaluate delegate outcomes and compliance.
    
  • Develop reports and analyses that translate complex data into actionable insights.
    
  • Identify trends, risks, and improvement opportunities across delegated programs.
    
  • Communicate findings clearly to support informed decision-making.

• Support Delegate Oversight & Improvement Initiative
  
  • Complete comprehensive audits based on state and federal regulatory requirements.
    
  • Analyze delegate performance against contractual, regulatory, and quality standards.
    
  • Partner with internal teams to identify gaps and recommend improvement strategies.
    
  • Monitor progress of corrective actions and validate sustained improvement.
    
  • Document findings and outcomes to support consistent oversight.

• Coordinate DHS & CMS Audit Support Activities
  • Support preparation for DHS and CMS site audits through data validation and reporting.
  • Collaborate with delegates and internal stakeholders to gather required documentation.
  • Respond to audit requests with accurate, timely, and defensible information.
  • Track audit findings and support resolution and follow-up activities.

• Drive Cross-Functional Data Integration & Collaboration
  • Partner with clinical, operational, compliance, and analytics teams to align information.
  • Ensure data consistency across reports, submissions, and oversight tools.
  • Address discrepancies through root-cause analysis and coordination.
  • Promote shared understanding of delegate performance across the organization.

• Serve as an Analytical Resource & Contribute to Process Improvement
  • Provide guidance to peers on metrics interpretation, reporting standards, and analysis methods.
  • Identify opportunities to improve analytical tools, workflows, or oversight processes.
  • Recommend enhancements that strengthen accuracy, efficiency, and usability.
  • Share best practices that advance delegate improvement and analytical maturity.

Required Qualifications 

• Bachelor's degree in Nursing, Social Work, Healthcare Administration or related degree and / or equivalent work experience in related field
• 5+ years of work experience beyond degree

Preferred Qualifications 

• Experience with care coordination, care or case management, and working with government programs strongly preferred
• Audit experience
• Experience and knowledge of Medicaid and SNP products
• Project management or program management experience
• Microsoft Office proficiency, including Word, PowerPoint and Excel

This position is a Remote role. To be eligible for consideration, candidates must have a primary home address located within any state where Medica is registered as an employer - AR, AZ, FL, GA, IA, IL, KS, KY, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WI

The full salary grade for this position is $70,200 - $120,400. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $70,200 - $120,400. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data.  In addition to compensation, 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.  

The compensation and benefits information is provided as of the date of this posting. Medica’s compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.  

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. 

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.