Director Medicare Product Performance

JOB REQUIREMENTS: Description Medica is a nonprofit health plan withmore than a million members that serves communities in Minnesota,Nebraska, Wisconsin, Missouri, and beyond. We deliver personalizedhealth care experiences and partner closely with providers to ensuremembers are genuinely cared for. We're a team that owns our work withaccountability, makes data-driven decisions, embraces continuouslearning, and celebrates collaboration - because success is a teamsport. It's our mission to be there in the moments that matter most forour members and employees. Join us in creating a community of connectedcare, where coordinated, quality service is the norm and every memberfeels valued. The Director of Medicare Product Performance is a keyleader responsible for driving the financial, operational, andcompetitive success of Medica's Medicare portfolio - spanning MedicareAdvantage (MA), Medicare Supplement and Medicare Cost Plans. This roleprioritizes and executes performance improvement initiatives across thesegment's critical business levers - membership growth and retention,operating margin, and operational excellence - while ensuring compliancewith CMS requirements and sustained competitive differentiation. Thisrole accelerates Medicare segment performance by connecting strategy toexecution and aligning the matrix around the KPIs that matter. Throughrigorous governance, decisive problem-solving, and clear executivecommunication, the Director ensures Medica's Medicare products arefinancially sound, operationally reliable, compliant, andmarket-competitive - delivering superior value to members, providers,and the enterprise. Key Accountabilities Product Performance LeadershipDefines and monitors Key Performance Indicators (KPIs) aligned toMedicare bid targets and segment goals; establishes transparentreporting to communicate goals and execution across the organization.Partners with cross-functional teams (network, pharmacy, clinicalprograms, Stars, risk adjustment, finance, actuarial, operations) tooptimize drivers of competitiveness and address outliers. Identifiesperformance gaps and leads cross-functional remediation plans, ensuringtimely execution and measurable improvement. Manages programdeliverables and holds matrixed partners accountable for on-time,high-quality completion of priority initiatives. Regularly monitorsperformance of core KPIs to ensure products are performing as expected:Financial & Revenue: Premium and risk-adjusted revenue, margin, MLR.Medical & Pharmacy Cost: Trend drivers, utilization, site-of-careoptimization, formulary effectiveness, specialty pharmacy. Quality &Risk Programs: Medicare Stars domains, HEDIS/CAHPS, risk adjustment (RAFaccuracy), coding completeness. Membership & Market Performance:Enrollment growth, retention/churn, attribution accuracy, product...For full info follow application link. Equal Opportunity Employerincluding Veterans and Disabled Individuals APPLICATIONINSTRUCTIONS: Apply Online: ipc.us/t/27417E01B6CE4977

Created: 2026-01-26