Vice President, Clinical

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 Vice President of Clinical Performance is a strategic physician leader responsible for driving clinical excellence, optimizing medical cost management, and advancing population health initiatives. This role will lead efforts to align clinical performance with organizational goals through data-driven utilization management, value-based care strategies, and collaborative provider partnerships. The VP will serve as a key clinical executive, fostering a culture of accountability, innovation, and continuous improvement across the care continuum.

• Clinical Strategy & Leadership
• 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
• Provider Partnership
  • 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
• Population Health & Value Based Care
  • Design and implement population health strategies that improve health outcomes
  • Support care coordination, and chronic disease management initiatives
• Clinical Performance Management & Data Insights
  • 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

• 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

• Reduction in avoidable utilization (e.g., ED visits, readmissions)
• Achievement of medical cost targets
• Member and Provider engagement and satisfaction scores
• Population health outcomes (e.g., chronic disease control, preventive care rates)

This position is an Office role, which requires an employee to work onsite at our…