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 Provider Network Data Analyst III ensures the accuracy, integrity, and timely distribution of provider data across Provider Network Operations and Management (PNOM) systems and databases. This role leads complex data analysis, validates end-to-end data flows, and proactively identifies improvements that enhance automation, efficiency, and reliability. It partners closely with IT teams, vendors, and network stakeholders to troubleshoot issues and drive system, workflow, and process enhancements. Operating with minimal supervision, the Analyst III serves as a data subject-matter expert and resource to others while contributing strategically to network readiness and operational performance. Performs other duties as assigned.
Key Accountabilities - Ensure Provider Network Data Integrity & Accuracy
- Monitor and validate provider data across PNOM systems to ensure completeness and consistency.
- Perform complex data analysis to identify discrepancies, trends, and root causes of errors.
- Resolve data quality issues through investigation, correction, and coordination with partners.
- Maintain documentation and controls that support audit readiness and data governance.
- Manage Data Distribution & System Interfaces
- Oversee timely and accurate distribution of provider data to internal systems, vendors, and downstream consumers.
- Validate inbound and outbound data feeds to ensure alignment with specifications and business rules.
- Coordinate resolution of interface or transmission issues to minimize operational disruption.
- Ensure data updates support provider directory accuracy, claims processing, and operational workflows.
- Partner with Tech & Vendors on Issue Resolution & Enhancements
- Collaborate with Tech and external vendors to troubleshoot complex system or data issues.
- Translate business and operational requirements into clear data or system needs.
- Participate in system enhancement initiatives, testing, and implementation activities.
- Provide data expertise to support workflow redesign and system optimization efforts.
- Drive Process Improvement & Automation
- Proactively identify opportunities to streamline, automate, or standardize provider data processes.
- Analyze current workflows to reduce manual effort, errors, and cycle time.
- Recommend enhancements that improve scalability, efficiency, and data reliability.
- Support adoption of improved processes through documentation and collaboration.
- Serve as a Data Subject-Matter Resource
- Provide guidance to colleagues on provider data standards, systems, and best practices.
- Support cross-functional partners by explaining data structures, dependencies, and impacts.
- Review peer work or outputs to promote consistency and quality.
- Share insights and lessons learned that strengthen team capability and performance.
- Other duties as assigned
- Assist with weekly, monthly and quarterly reporting for the department
- Help support the monthly audit of provider data
- Create and monitor the provider directory accuracy process for all business segments throughout the year
- Collaborate with internal IT partners and external vendors
Required Qualifications - Bachelor's degree or equivalent experience in related field
- 5+ years of reporting and / or datamining experience, beyond degree
- Intermediate to Advanced Microsoft Excel skills
- Basic understanding of SQL
Preferred Qualifications - Healthcare/Health Insurance experience
- Familiarity with the following systems/applications: Symfact, Copis, Toad and Service Now
This position is an Office role, which requires an employee to work onsite at our Minnetonka, MN office, on average, 3 days per week.
The full salary grade for this position is $56,600 - $97,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $56,600 - $84,840. 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.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.
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