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UnitedHealthcare Market Chief Medical Officer Employer & Individual - New York

Company: UnitedHealth Group
Location: Chicago
Posted on: November 27, 2022

Job Description:

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) UnitedHealthcare's Employer & Individual Market CMOs serve as the local senior clinical executive for the Commercial line of business in their respective states, with accountability for:

  • Achieving defined clinical outcomes, affordability goals and growth targets, in partnership with their health plan leadership team
  • Providing clinical insight into market data and implementing tailored interventions to address clinical trends and opportunities for their state or region
  • Serving as a central health plan leader accountable to facilitate coordination with UnitedHealthcare and Optum national clinical and operational functions
  • Actively engage and help drive performance with market-level quality, network, and compliance teams
  • Building and deepening relationships with area hospitals, physicians, and other health care providers
  • Advocate for UnitedHealthcare's clinical value story, evidence-based medical policies, and member health with government/state regulatory entities, professional and medical society chapters, employers, and as part of external communications and media relations
  • Providing subject/specialty based clinical expertise and leadership to the enterprise, as needed If you are located in New York, you will have the flexibility to telecommute as you take on some tough challenges. Primary Responsibilities:
    • Clinical Affordability - CMOs are responsible for achieving their assigned incremental savings goal and support the national savings target for the year. Driving savings is a two-pronged, data-driven approach of local response and national implementation, where CMOs lead targeted clinical inventions to address local market trends and needs, and support on-the-ground alignment with national utilization management programs. Inform and drive local and national affordability initiatives: CMOs are expected to apply healthcare economics insights and escalate local issues and trends
    • Network / Provider Engagement - The CMO serves as the local clinical point of contact for physicians, systems, and other care providers and with UnitedHealth Networks colleagues. Key activities include UHC's Accountable Care Platform, value-based contracting, clinical practice transformation, patient-centered medical homes, and transparency initiatives such as UnitedHealth Premium Designation and/or High Performing Physicians. The CMO meets regularly with hospitals and physician groups and shares data on quality and efficiency improvement opportunities and developing action plans for sub-optimal results
    • Market Relationships - The CMO is the clinical face of UnitedHealthcare to elected officials, policy makers, plan sponsors, medical and professional societies, news media, and community-based organizations. The CMO is engaged in regular, proactive dialogue with our external constituents to advance evidence-based medicine and support best practices in health care delivery
    • Quality & Compliance - The CMO maintains a solid working knowledge of all government mandates and provisions, working across the enterprise to implement and maintain compliant clinical programs and procedures. The CMO also supports quality improvement efforts as measured by Star Ratings, HEDIS, CAHPS, HOS and other national and company metrics. The CMO partners with UHC Compliance to ensure clinical management regulatory obligations regarding clinical management are met. Market CMOs also chair required Quality Oversight Committees at a market/regional level You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:
      • Active and unrestricted New York Medical License
      • Active/unrestricted Board Certified in an ABMS or AOBMS specialty
      • 5+ years of clinical practice experience
      • Solid knowledge of managed care industry
      • Solid knowledge of health care utilization data and analytics
      • Familiarity with current medical issues and practices
      • Capable to quickly become facile with UHC/UHG specific data systems
      • Proficiency with Microsoft Office applications (Outlook, Word, Excel, PowerPoint)
      • Superior presentation skills for both clinical and non-clinical audiences
      • Excellent interpersonal communication skills and ability to influence in executive settings
      • Proven ability to identify an improvement opportunity through data, implement a solution and achieve measurable impact. Solid data analysis and interpretation skills; KPI metrics driven
      • Ability/experience in developing collaborative relationships with health system clinical leadership
      • Proven ability to develop relationships with network and community physicians and other providers
      • Ability to travel within the assigned market, including being fully vaccinated and boosted
      • 30% travel
      • Reside in, or be willing to relocate to assigned market(s); preferably within proximity to UHC corporate offices
      • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation Preferred Qualifications:
        • Advanced Business, Public Health, Medical Management degree
        • Health plan experience in similar leadership capacity
        • Knowledge of New Hospitals and providers
        • Solid team player and team building skills
        • Solid negotiation and conflict management skills
        • Creative problem-solving skills
        • Strategic thinking with proven ability to communicate a vision and drive results To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm) All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: UnitedHealth Group, Chicago , UnitedHealthcare Market Chief Medical Officer Employer & Individual - New York, Healthcare , Chicago, Illinois

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