Business Optimization Manager Jobs in Madison, WI

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.  

This role supports Medica’s Clinical Optimization team by analyzing, documenting, and operationalizing business and regulatory requirements across clinical systems and workflows. The Business Analyst III partners with cross-functional stakeholders to translate business needs into system and process solutions, supporting strategic initiatives and continuous optimization efforts.

This position plays a key role in enabling transformation initiatives through requirements management, process analysis, and system expertise across clinical platforms and integrations. Performs other duties as assigned. 

Key Accountabilities 

• Requirements & Solution Development
  • Gather, analyze, and document business and system requirements across clinical workflows and technologies
  • Translate stakeholder needs into functional requirements, user stories, and process documentation
  • Collaborate with IT and vendor partners to support solution design, build, and validation
  • Support testing, implementation, and ongoing enhancements

• Process Optimization & Transformation Support
  • Gather, analyze, and document business and system requirements across clinical workflows and technologies
  • Translate stakeholder needs into functional requirements, user stories, and process documentation
  • Collaborate with IT and vendor partners to support solution design, build, and validation
  • Support testing, implementation, and ongoing enhancements

• System Expertise & Stakeholder Support
  • Serve as subject matter expert on clinical systems, workflows, and integrations
  • Provide guidance to business stakeholders on system capabilities and best practices
  • Support issue resolution by analyzing system behavior and coordinating with IT and vendors
  • Participate in cross-functional initiatives requiring system and process expertise

• Data, Reporting & Governance
  • Support data analysis, reporting, and validation related to clinical systems and operations
  • Participate in data governance efforts to ensure data quality, accuracy, and compliance
  • Coordinate with reporting teams and stakeholders to support operational and regulatory reporting
  • Help ensure proper handling and management of clinical data across systems

Required Qualifications 

• Bachelor's degree or equivalent experience in related field
• 5+ years of relevant experience in business analysis, preferably in healthcare or clinical systems
• Experience working with cross-functional teams, including IT and business stakeholders
• Strong analytical and problem-solving skills with attention to detail 
• Ability to translate complex business needs into actionable requirements 
• Excellent communication and stakeholder collaboration skills  
• Strong organizational skills with ability to manage competing priorities 
• Ability to work independently and drive outcomes in a fast-paced environment

Preferred Qualifications 

• Experience with clinical systems, utilization management, or care management workflows
• Proficiency in data and reporting tools (e.g., SQL, Excel, Power BI, Tableau)
• Experience working with vendor-managed platforms and integrations

This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, MN, or Madison, WI.

The full salary grade for this position is $78,700 - $134,900. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $78,700 - $134,900. 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.