Competing Values — Scale the Clan Without Killing It at Meridian Cardiac

A four-round, advanced leadership and organizational-behavior simulation set inside Meridian Cardiac Systems, LLC, a USD 310M medical-device firm in Plymouth, Minnesota (19% EBITDA, 1,150 staff). You are the newly promoted General Manager of the 140-person Clinical Operations unit — a beloved, slow, craft-driven team that has posted 98%+ customer satisfaction for eleven straight years but has never scaled a process, published a metric, or operated under an external SLA. Corporate just won a national contract and handed you a mandate to grow supported devices from 40,000 to 120,000 in eighteen months: throughput must climb from ~3,300 to ~10,000 monitoring cases/month, under a 24-hour clinical-response SLA (USD 25,000 per breach, capped USD 1.5M/yr) and FDA 21 CFR 820 complaint-handling exposure — without losing the two senior engineers who personally hold 30% of the top hospital relationships. Using the Competing Values Framework (Quinn & Rohrbaugh; Cameron & Quinn), the OCAI diagnostic, and Quinn's eight competing managerial roles, you (1) diagnose the unit's current and preferred culture across Clan, Adhocracy, Market and Hierarchy and name the gaps as imbalance rather than deficiency; (2) set a deliberate position on the two CVF tensions — flexibility vs control and internal vs external — by allocating a 100-point leadership-attention budget and choosing concrete moves, knowing over-rotation to Market/Hierarchy breaks the clan and staying purely Clan/Adhocracy misses the throughput gap and triggers SLA penalties; (3) build a leadership role portfolio that spans competing quadrants — demonstrating behavioral complexity — under live pressure from the CEO, the two key engineers, and an escalating near-miss adverse-event report, while deliberately keeping the non-negotiable regulatory control; and (4) present and recover a sequenced 90-day plan when a mid-quarter signal shows satisfaction slipping from 98% to 91% and throughput still 20% short — recalibrating the balance rather than whipsawing it. Spend is bounded by a USD 2.0M transition budget the “just hire 120 people” path will blow. The math rewards both/and balance and punishes the five classic errors — pathologizing the culture, over-rotating to control, comfortable same-quadrant role selection, announce-and-move-on, and whipsawing on the first bad signal. Final KPIs track Culture Fit, Throughput Readiness, Stakeholder Trust, and Role Balance.