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Job Details

UnitedHealth Group

Vice President, Population Health - UnitedHealthcare Community Plan of Tennessee - Brentwood, TN


Home Health


Brentwood, Tennessee, United States

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)

The Community & State (C&S) Vice President of Population Health provides state oversight of core clinical program adherence and outcomes for the state of Tennessee. Care populations include but are not limited to Medicaid, Children’s Health Insurance Program (CHIP), Dual Special Needs Plan (DSNP), Private Duty Nursing (PDN), behavioral health (BH), and maternity members. This leader will work in partnership with the Complex Care Product (Long Term Services and Supports), Local Affordability, Operations, and Provider Relations teams in addition to local health plan executive leadership.

Primary Responsibilities:

  • Implementation and oversight of the TN C&S integrated care management program, including but limited to assessments, workflows, policies, processes, job aids, and staffing models
  • Health Plan clinical director and/or manager onboarding, training, and support
  • Coach and mentor team members on performance; as well as aid in professional development plans using Our United Culture, Common Language of Leadership (CLL), and other tools as appropriate
  • Act as Subject Matter Expert (SME) for Request for Proposal (RFP) development and implementation for the TN C&S market for clinical and population health matters
  • Provide thought leadership through ongoing & annual evaluation of the care management, and population health, programs to ensure efficacy and efficiency, as well as appropriate human capital utilization
  • Partner with the health plan leaders to adapt evidence-based clinical interventions as appropriate to better meet the needs of the population
  • Partner with the compliance leads and adherence teams on all compliance-related topics, and ensure, from a clinical, operational perspective, there is compliance with all clinical care management and documentation requirements, policies, and procedures
  • Support clinical internal and external audits and accreditation activities, acting as the health plan SME and/or spokesperson when appropriate
  • In partnership with the Quality team, develop a work plan geared towards continuous quality improvement inclusive of clinical care management operations and performance
  • Evaluate, develop, and/or utilize performance and productivity dashboards/data to support team members achieve successful delivery of job roles and responsibilities
  • Support and implement corrective action and/or remediation plans to ensure Contractor Risk Agreement (CRA), Model of Care (MOC), and National Committee for Quality Assurance (NCQA) Care Management adherence
  • Drive consistency among C&S clinical operations models and performance
  • Collaborate with National Affordability Team to strategize and remediate affordability projects within designated markets
  • Serve as the link between health plan requirements and national support functions, including requests for program changes, implementation, training, etc., balancing local customization with national scale and efficiency
  • Understand state and federal legal and contractual regulations and requirements; translate requirements into operational metrics and protocols

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:

  • Undergraduate degree or equivalent experience required in a healthcare-related field
  • 5+ years of experience including Managed Care experience, healthcare administration, and or healthcare consulting experience including: healthcare operations, clinical services, networks, products, and benefits
  • 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 Qualification:

  • Graduate degree in healthcare or management-related field

Soft Skills:

  • Vision - shaping and orchestrating a compelling, forward-looking vision that guides each business (e.g., their region) and contributes to the enterprise (e.g., C&S)
  • Plan - creating and executing an operational annual plan to accomplish the strategy (clear, concise work plans for the ad hoc initiatives they are supporting)
  • Structuring and Staffing - attracting and selecting staff and structuring roles and responsibilities; deploying aligned staff whose capabilities enable the organization to achieve its goals (e.g., being able to clearly articulate their role to the HSDs/clinical leadership as well as supporting those individuals to effectively and efficiently do their jobs)
  • Progress & Results - monitoring and measuring progress against plan; providing real-time supportive and corrective feedback and assistance
  • Represent & Respond to Stakeholders - preparing and delivering presentations to and fostering relationships with critical stakeholders; recognizing and responding to the diverse needs of the key inside and outside stakeholders (e.g., C&S clinical leadership)
  • Conflict Management - mediates the inevitable individual, team, and business unit conflicts; offering assistance and direction moving to productive resolution
  • Customer-focused; proven ability to handle complex situations, and resolve conflicts and issues effectively. Sensitive to how people and the organization function
  • Demonstrate ability to translate strategic objectives into action plans and lead/motivate teams to execute plans effectively and the flexibility to adapt and change direction as needed

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 Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

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.