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Medica · 10 hours ago

Vice President, Clinical Performance

Hopkins, MN

Full-time

Hybrid

Senior Level, Lead/Staff

$280K/yr - $420K/yr

10+ years exp

Medica is a nonprofit health plan serving communities across multiple states, dedicated to delivering personalized healthcare experiences. The Vice President of Clinical Performance is a strategic physician leader responsible for driving clinical excellence, optimizing medical cost management, and advancing population health initiatives through data-driven strategies and collaborative partnerships.

Health CareMedical

No H1B

Hiring Manager

Ericka Johnson

Responsibilities

Lead the development and execution of clinical performance strategies aligned with organizational goals

Serve as a clinical advisor to executive leadership on matters related to utilization, population health and cost containment

Champion evidence-based practices and clinical innovation to improve outcomes and reduce variability in care

Coordination with Utilization Management (UM), Care Management, Stars, Pharmacy, Quality, etc

Leads the clinical aspects of our provider partnerships and ACO strategies

Creates strategy for leveraging and sharing actionable insights with our provider partners to drive clinical and business outcomes that enhances outcomes both our providers and Medica with a focus on our member experience

Design and implement population health strategies that improve health outcomes

Support care coordination, and chronic disease management initiatives

Lead the strategy to clinically support design for Medicare, Medicaid, Commercial, and Individual Family Business products

Oversee collaboration with analytics, actuarial, and finance teams to ensure data insights are leveraged to inform utilization, cost, and population health strategies

Direct the translation of data and performance trends into actionable strategies, guiding internal teams and provider partners to achieve measurable improvements in outcomes and affordability

Provide strategic leadership defining and prioritizing clinical performance metrics that align with enterprise goals and drive organizational accountability

Monitor key performance indicators (KPIs) and report progress to executive leadership

Ensure Medica’s offerings are affordable to our members and result in high quality clinical outcomes

Qualification

MDDO degreeActive medical licenseUtilization managementPopulation healthValue-based careClinical data interpretationLeadership experienceStrategic thinkingCommunication skillsInterpersonal skillsCollaboration skills

Required

MD or DO degree required, MBA or other advanced degree desirable

Active and unrestricted medical license

Minimum of 10 years of clinical/ Health Plan/ ACO experience, with at least 5 years in a leadership role

Proven track record in utilization management, population health, or value-based care

Experience working in integrated delivery systems, health plans, or accountable care organizations (ACOs) is required. Health Plan experience is highly desirable

Strategic thinker with strong business acumen and clinical credibility

Exceptional communication and interpersonal skills

Ability to lead through influence and collaboration across multidisciplinary teams

Proficiency in interpreting clinical and financial data to drive decision-making