Sr Director Quality Operations & Improvement

Overview

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 are 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 is 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.

• Strategic Leadership & Long Range Planning
  • Partner with the VP of Enterprise Quality & Stars to develop and execute multi-year strategies for quality, compliance, and member experience
  • Collaborate with the Population Health and Quality Medical Director to integrate clinical governance into quality improvement and wellness initiatives
  • Align strategies across all lines of business to ensure consistency and scalability
• Staff Development & Leadership
  • Build and mentor high-performing teams; create career development pathways for directors and staff
  • Foster a culture of accountability, collaboration, and continuous improvement
  • Implement succession planning and leadership development programs within the division
• Technology & Innovation
  • Partner with IT and Analytics to advance technology platforms for credentialing, accreditation, and quality measurement
  • Champion automation and digital tools to improve operational efficiency and data integrity
  • Ensure integration of predictive analytics and real-time dashboards for decision-making
• Operational Integration
  • Oversee Quality Operations (credentialing, accreditation, Model of Care compliance), Quality Improvement (population health, health equity, Medicaid programs), and Wellness & Health Promotion
  • Streamline workflows to reduce duplication and improve efficiency across compliance and improvement functions. Ensure consistent application of evidence-based standards and regulatory requirements across all lines of business
• Enterprise Partnerships
  • Collaborate with Medicare, Medicaid, Commercial, and IFB segments to align quality strategies with product goals
  • Serve as a liaison to provider networks, pharmacy, and risk adjustment teams for integrated quality interventions. Represent Enterprise Quality & Stars in enterprise governance forums and strategic planning sessions
• Performance Measurement
  • Establish KPIs for compliance, health equity, and wellness engagement; report progress to executive leadership. Use data-driven insights to forecast performance and inform interventions
  • Ensure readiness for audits and accreditation reviews with zero critical findings

• Bachelor's degree in healthcare administration, public health, or equivalent experience in related field;
  Master's degree preferred
• 10 years of experience beyond degree in healthcare quality leadership, with experience in accreditation, compliance, and population health

• Proven ability to lead multi-disciplinary teams and manage complex portfolios
• Strong knowledge of NCQA, CMS, and state regulatory requirements
• Expertise in strategic planning, resource optimization, and performance analytics

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 $150,000 - $257,200. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $150,000 - $225,015. 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 base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays,…