Chief Medical Officer - Community Plan of Louisiana

UnitedHealth Group • Metairie, LA

301d • $343,500 - $516,500 • Remote

About The Position

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Community Plan of Louisiana Chief Medical Officer (CMO) has accountability for driving clinical excellence in alignment with state regulatory requirements and state & community health priorities. The CMO will achieve this, through partnership with local health plan leaders and enterprise clinical operations, by providing oversight and guidance around quality improvement, appropriate inpatient and outpatient utilization, affordability, growth, regulatory compliance, and health system transformation. The CMO will also work with the provider network team to develop solid partnerships with local healthcare systems and providers. This position reports to the Community Plan of Louisiana Chief Executive Officer and has a dotted line relationship to the UnitedHealthcare Chief Medical Officer. The CMO will also work closely with the health plan's clinical leadership to develop and implement clinical programs for people with complex social driver of health (SDOH), medical and behavioral health needs to be empowered in their healthcare decisions. This is a fast-paced working environment that requires the ability to multitask with attention to detail and excellent organizational skills.

Requirements

• Louisiana licensed physician active and unrestricted; Board Certified in an ABMS or AOBMS specialty required
• Must reside in Louisiana
• 5+ years of clinical practice experience
• 2 + years of Quality management experience
• Experience engaging in health equity work and/or with communities that are historically underserved/underrepresented in healthcare
• Solid knowledge of managed care industry and Medicaid / Medicare experience
• Understanding of the LTSS population
• Familiarity with current medical issues and practices nationally and locally
• Proficiency with Microsoft Office applications
• Proven solid leadership skills, as demonstrated by continuously improved results, team building, and effectiveness in a highly matrixed organization
• Proven excellent interpersonal communication skills
• Proven superior presentation skills for both clinical and non-clinical audiences
• Proven ability to develop relationships with network and community physicians and other providers
• Proven excellent project management skills
• Proven solid data analysis and interpretation skills; ability to focus on key metrics
• Proven solid team player and team building skills
• Proven strategic thinking with proven ability to communicate a vision and drive results
• Proven solid negotiation and conflict management skills
• Proven creative problem-solving skills

Nice To Haves

• Experience working with Louisiana Department of Health and Welfare
• Bilingual - English and Spanish
• Proven leadership positions in Louisiana medical associations / societies

Responsibilities

• Quality and Affordability - The CMO has primary responsibility and accountability for Total Medical PMPM performance and targets for the local health plan.
• Clinical Excellence - The CMO provides oversight to the HEDIS and CMS Stars data collection process and local performance strategy.
• Relationship Equity and State Compliance - The Health Plan CMO maintains a solid working knowledge of all Louisiana government mandates and provisions related to clinical services.
• Health Equity - The CMO has a leadership role in helping develop a strategy to identify clinical areas where there are disparities in health outcomes across groups.
• Innovation - The CMO leads the clinical interface with care providers and UHN colleagues in efforts to transform the health system.
• Growth - The CMO delivers the clinical value proposition focused on quality, affordability and service, in support of growth activities of the health plan.
• Focused Improvement - The CMO is responsible for identifying opportunities through participation in regional and local market reviews.
• Grievances and Appeals - The CMO maintains an active liaison with UnitedHealth Appeals & Grievances team.

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Executive
• Industry: Insurance Carriers and Related Activities
• Education Level: No Education Listed