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Medica · 17 hours ago

Sr Director Quality Operations & Improvement

Hopkins, MN

Full-time

Hybrid

Director/Executive

$150K/yr - $225K/yr

10+ years exp

Medica is a nonprofit health plan serving communities in multiple states, dedicated to providing personalized health care experiences. The Sr. Director of Quality Operations & Improvement will lead strategic initiatives and operational oversight for quality functions, ensuring alignment across various lines of business while optimizing resources and advancing technology capabilities.

Health CareMedical

No H1B

Responsibilities

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

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

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

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

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

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

Qualification

Healthcare quality leadershipAccreditation compliancePopulation health managementStrategic planningPerformance analyticsResource optimizationContinuous improvementData-driven decision makingTeam leadershipCollaborationMentoring