Working at Medica

woman in Suit

Medica values its employees and has created a great place to work and grow as a professional. We employ over 1,200 people, based mainly at our Minnetonka campus. Our employees take pride in their work and serving the needs of our members and our community. We value diversity and inclusion and are committed to a workplace that reflects our community and the people we serve.

Career Fields

Our administrative staff provides support within our entire organization. A member of the administrative staff may be the face of the Company often times receiving calls and speaking to visitors requiring poise and people skills. In addition, the responsibility includes a working knowledge of leader's duties to be able to effectively manage his/her calendar and schedule appointments. Administrators must demonstrate outstanding accuracy, customer service, accountability, communication and organizational skills. S/he must be able to maintain confidentiality and discretion in handling confidential information and data.

The Facilities team provides a safe, healthy and efficient work environment for Medica. It purchases and manages all aspects of office space and equipment, and coordinates employee moves, additions and changes with HR and IT. Facilities manages building construction, maintenance, and real estate issues, and supports regional office facilities. Facilities also manages building Security & Safety, the Conference Center, refreshment center service and janitorial services, shredding, parking, first aid and safety.

Staff in the clinical and pharmaceutical areas have overall responsibility for clinical quality and outcomes, utilization management, member health support programs, network management, and pharmacy. The departments within this business area analyze health care cost and utilization trends, and develop programs, interventions and other strategies to prevent waste and improve care and health. Several initiatives involve working closely with our network of providers to improve quality at the point of care, while reducing the cost and rewarding better outcomes.

These Positions plan, organize and evaluate health plan programs; collaborate with other health specialists to determine health needs, develop health goals and determine the availability of professional health services; develop and execute community health programs.

The Customer and Provider Service department delivers customer service to Medica's members and all providers. It provides a wide range of assistance to members and providers, including information on benefits, enrollment, eligibility, pre-existing conditions and claims. Employer representatives, brokers, insurance agents and consultants also contact Customer Service regarding many of the same issues. This area handles administration of the appeals process for commercial members; and its Provider Service Center answers inquiries from providers, including questions about claims, electronic transactions, medica.com, and provider education materials.

Executives are responsible for implementing the strategic goals and objectives of the organization and give direction and leadership toward the achievement of the organization's philosophy, mission, strategy, and its annual goals and objectives. Our people are our greatest asset. Our executives are committed to building a workforce that reflects the strength and character of the members and communities we serve. We promote a spirit of openness, diversity, discovery and learning in order to live our mission and achieve our vision.

Finance develops operating plans, identifies financial opportunities and risks, establishes and monitors progress toward financial targets, and analyzes operating results. Finance provides the analytical support for provider contracting, and is responsible for identifying and analyzing healthcare cost drivers to ensure that medical expense trends are appropriately reflected in pricing.

The Actuarial department develops assumptions and pricing for Medica's current products and determines base prices for all new products. It also provides risk analysis and other financial support to each of Medica's business segments. The department handles regulatory rate filings, and works with other departments in the development of medical trend forecasts and financial reserves.

Commercial Finance & Underwriting is responsible for pricing Medica's commercial products and monitoring the financial results to ensure that we meet our financial and membership goals. The department works closely with Sales, Product, and Actuarial in the development of, and pricing for, new products. They also collaborate with Finance and Health Care Economics and Health Management department to understand and influence the impact of provider agreements and care cost initiatives on future medical claim costs. The Internal Audit department audits the financial statements, reporting and operations of Medica and its vendors, as directed by the Board of Directors' Audit Committee.

The Government Programs division is responsible for the administration of government products and the managing of Medica's contracts with networks out-sourced to other organizations. Government Programs includes Medicare and Minnesota Health Care Programs (Medicaid and MinnesotaCare) product lines. Medica State Public Programs serves Minnesota Health Care Program enrollees, and the Center for Health Aging serves members of Medicare products. This division is responsible for the design and development of the products themselves and the customer service and operations functions for each product. This division also manages Medica's complementary networks, including its behavioral, dental and chiropractic networks.

The Data Analytics roles handle Quality Measurement, Clinical Analysis, Health Mgmt Programs Analysis, and Healthcare Cost Analysis, Big Data, and Enterprise Data Analysis, for Medica. Data Analytics manages our quality and patient satisfaction surveys, develops and evaluates health management programs, analyzes and forecasts cost trends, and manages cost savings initiatives. Data Analytics also directs clinic initiatives and pilots, the development of preferred networks, and annual preventive health reminders. Data Analytics works with health plan business data for reporting and process improvement planning. Staff work to assess, research, and make recommendations regarding business intelligence technology solutions.

Human resources includes positions that apply policies and procedures relating to human resources: employee recruitment, selection, training, development, retention, promotion, compensation, and employee relations. Incumbents plan and manage compensation, benefits, HRIS programs, manage the employee relations programs; talent acquisition and retention functions, and plan employee wellness programs.

Medica Learning Center (MLC) helps employees get the knowledge and skills they need to achieve Medica's business objectives. MLC provides the following types of training programs and services: Services provided include new employee orientation, new employee training for mission-critical areas of the organization, including the six call centers and Care Management; technical, functional and industry-specific training, including training on Medica's proprietary software systems; Microsoft Office desktop software training; professional development and business skills training; leadership development, customized programming for work units to meet specific needs; organizational development and one-to-one coaching on performance and development.

The Information Technology (IT) department is responsible for the IT functions of the enterprise, including the technical infrastructure, communication networks and inter-connectivity (voice and data), software development, information management, computer systems operations, electronic security, services and internal/external portals. It is also responsible for overseeing all IT vendors and creating and maintaining all IT policies and procedures.

The Legal business unit has responsibility for Medica's legal affairs, compliance efforts, government relations, and public policy. It provides legal advice and analysis, and partners with the business to identify legal issues and create effective solutions. The department provides advice and counsel to Medica's Board of Directors, committees, management and staff. It also drafts many purchaser, provider, vendor, broker and coverage contracts. It manages a corporate-wide records management program and provides public policy information.

The Marketing and Communications business unit is responsible for Medica's marketing, public relations, communications and strategic planning. It provides leadership and direction for market research, marketing planning, brand strategy, product development, advertising, promotions, marketing communications, public relations, and member, provider, and employee communications.

The Network Management department is responsible for contract negotiation and network maintenance for physician, hospital and ancillary networks in the Medica Service Area.

The Operations area is responsible for a wide variety of functions related to Medica's products. Included are enrollment, billing, claims processing and employer and provider contract implementation, as well as other general operations.

The Sales and Account Management area is responsible for new business and renewal sales, strategic support, and account management for customers. It is also responsible for Medica's partnership throughout its service area with employers, brokers and consultants.

Account Management focuses on developing and retaining business that is important to Medica's strategic growth. Sales and Account Management positions directly involved in the selling and account management of company products and services. Incumbents contact potential and current customers in person and via phone to sell and maintain member contracts.