CMO - Community Plan of New York

UnitedHealth Group•Mount Kisco, NY

18d•$292,300 - $438,500•Remote

About The Position

This is a rare opportunity to lead clinical strategy and performance for one of the largest and most complex Medicaid health plans in the country. The Chief Medical Officer (CMO) will shape how care is delivered to hundreds of thousands of New Yorkers, with direct accountability for medical cost trends, quality outcomes, and value-based provider performance. The CMO is the senior clinical executive for UnitedHealthcare Community Plan of New York and a key member of the executive leadership team. This role owns the clinical performance of the health plan, including total cost of care, quality, provider results, and clinical relationships with New York State. This is a true operating role. Success requires a physician leader who can translate data into action, influence providers and internal partners, and deliver measurable performance improvement at scale across a complex, matrixed organization. If you are NY state based, you will have the flexibility to work remotely as you take on some tough challenges.

Requirements

MD or DO with active, unrestricted New York physician license, or ability to obtain prior to start; New York-based practice familiarity strongly preferred.
Active board certification in an ABMS or AOA/AOBMS specialty.
5+ years of post-residency clinical practice experience.
Significant physician leadership experience in managed care, population health, or a risk-bearing provider organization
Solid understanding of Medicaid managed care, value-based care, and population health principles
Demonstrated success improving medical cost trend, utilization, or total cost of care
Proven ability to influence providers and deliver results in a matrixed organization
Proven solid data fluency and ability to translate insights into action
Proven executive presence with solid communication and problem-solving skills

Nice To Haves

Advanced degree in business, public health, or medical management
Experience in New York Medicaid managed care
Experience with HEDIS, P4P programs, and accreditation processes
Experience working with large provider systems, FQHCs, ACOs, or integrated delivery networks
Experience in physical and behavioral health integration
Experience using AI-enabled tools to improve communication, decision-making, or clinical operations

Responsibilities

Own and lead the clinical strategy to improve medical cost trend across all lines of business
Identify the highest impact drivers of cost, including inpatient, outpatient, emergency department, post-acute, and pharmacy spend
Use data and analytics to identify actionable trends, prioritize interventions, measure outcomes, and drive fact-based decision making
Partner with internal and external stakeholders to implement clinical programs that reduce unnecessary utilization and improve care delivery
Deliver clinical and financial performance, including total cost of care, quality incentive capture, and improvement in documentation and risk capture
Partner with quality leadership to improve performance on HEDIS, P4P measures, CAHPS, and other key quality indicators
Translate quality priorities to convert performance gaps into actionable provider and operational strategies
Support accreditation readiness and sustained clinical excellence
Ensure alignment between affordability initiatives and quality outcomes
Drive provider performance in cost and quality through data transparency, clinical engagement, and value-based partnerships
Partner with network leadership and UHN to expand and strengthen value-based care models
Lead high impact engagements with hospitals, FQHCs, ACOs, large physician groups, health homes, and other priority partners.
Influence physician behavior and clinical workflows to improve outcomes, utilization, and member experience
Maintain strong working knowledge of New York Medicaid managed care requirements and ensure compliant clinical oversight.
Build trusted relationships with state clinical leadership and represent the health plan credibly in clinical discussions with regulators and external stakeholders
Provide clinical oversight of medical necessity determinations, appeals/fair hearing clinical issues, and other physician-level governance responsibilities as required
Chair the Quality Improvement Committee and lead clinical governance across the organization
Ensure solid oversight of clinical policies, guidelines, and standards of care
Partner closely with the Health Services Director and clinical operations leadership to triage issues, remove barriers, strengthen execution, and maintain regulatory readiness
Lead through influence in a matrixed environment and establish clear accountability and alignment around clinical priorities and performance outcomes
Advance population health strategies to improve outcomes for complex Medicaid populations
Address social drivers of health and reduce disparities in access, quality, and outcomes
Identify and implement data-driven clinical programs that improve affordability, quality, and member experience
Promote a culture of innovation, accountability, and continuous improvement