UnitedHealthcare Market Chief Medical Officer E&I - Washington/PNW - Virtual
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)
If you are located in Lake Oswego, OR, you will have the flexibility to telecommute* as you take on some tough challenges.
UnitedHealthcare’s Market CMOs serve as the local senior clinical executive for their line of business, with accountability for:
- Achieving defined clinical outcomes, affordability goals and growth targets, in partnership with their health plan leadership team
- Provide 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
- Provides subject/specialty based clinical expertise and leadership to UCS and the enterprise, as needed
Primary Core Accountabilities
- 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 CMS Star Ratings, NCQA 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.
- Active and unrestricted Washington State or Oregon Medical License
- Board Certified in an ABMS or AOBMS specialty
- 5+ years of clinical practice experience
- Demonstrated knowledge of the Managed Care industry
- Experience with current medical issues and practices
- Demonstrated knowledge of health care utilization data and analytics
- 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
- Experience in developing collaborative relationships with health system clinical leadership
- Proven ability to develop relationships with network and community physicians and other providers
- Demonstrated excellent interpersonal communication skills and ability to influence in executive settings
- Proven superior presentation skills for both clinical and non-clinical audiences
- Proficiency with Microsoft Office applications (Outlook, Word, Excel, PowerPoint)
- Capable to quickly become facile with UHC/UHG specific data systems
- Reside in, or be willing to relocate to Washington State; preferably within proximity to UHC corporate offices
- Ability to travel within the assigned market—30% travel required
- 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
- Advanced Business, Public Health, Medical Management degree
- Prior health plan experience in a similar leadership capacity
- Solid team player and team building skills
- Demonstrated strategic thinking with ability to communicate a vision and drive results
- Proven negotiation and conflict management skills
- Demonstrated creative problem-solving skills
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 at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is 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.