M&R Market Chief Medical Officer - Missouri

UnitedHealth Group•Maryland Heights, MO

27d•$336,500 - $485,500•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 optimized. 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. They provide clinical insight into market data and implementing tailored interventions to address clinical trends and opportunities for their state or region. They also serve 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, and build and deepen relationships with area hospitals, physicians, and other health care providers. The CMO advocates 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. They provide subject/specialty based clinical expertise and leadership to UCS and the enterprise, as needed. If you are located in Missouri, you will have the flexibility to work remotely as you take on some tough challenges.

Requirements

Active and unrestricted Missouri Medical License
Reside in, or be willing to relocate to MO; within proximity to UHC corporate offices
Board Certified in an ABMS or AOA specialty
5+ years clinical practice experience
Solid knowledge of managed care industry
Familiarity with current medical issues and practices
Excellent interpersonal communication skills and ability to influence in executive settings
Superior presentation skills for both clinical and non-clinical audiences
Solid 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.
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—30%25 travel required
Proficiency with Microsoft Office applications (Outlook, Word, Excel, PowerPoint)
Capable to quickly become facile with UHC/UHG specific data systems
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
Candidates are required to pass a drug test before beginning employment.

Nice To Haves

Prior health plan experience in similar leadership capacity
Advanced Business, Public Health, Medical Management degree
Solid team player and team building skills
Strategic thinking with proven ability to communicate a vision and drive results
Solid negotiation and conflict management skills
Creative problem-solving skills

Responsibilities

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
Achieve their assigned incremental savings goal and support the national savings target for the year.
Drive 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, applying healthcare economics insights and escalating local issues and trends.
Serve as the local clinical point of contact for physicians, systems, and other care providers and with UnitedHealth Networks colleagues.
Engage in 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.
Meet regularly with hospitals and physician groups and shares data on quality and efficiency improvement opportunities and developing action plans for sub-optimal results.
Act as the clinical face of UnitedHealthcare to elected officials, policy makers, plan sponsors, medical and professional societies, news media, and community-based organizations.
Engage in regular, proactive dialogue with external constituents to advance evidence-based medicine and support best practices in health care delivery.
Maintain a strong working knowledge of all government mandates and provisions, working across the enterprise to implement and maintain compliant clinical programs and procedures.
Support quality improvement efforts as measured by CMS Star Ratings, NCQA Star Ratings, HEDIS, CAHPS, HOS and other national and company metrics.
Partner with UHC Compliance to ensure clinical management regulatory obligations regarding clinical management are met.
Chair required Quality Oversight Committees at a market/regional level.