E&I Market Chief Medical Officer MN/WI

UnitedHealth Group•Minnetonka, MN

29d•$238,000 - $357,500•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. 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 You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Requirements

Active and unrestricted MN/WI Medical License
Reside in, or be willing to relocate to MN/WI; 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
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

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
Excellent interpersonal communication skills and ability to influence in executive settings
Superior presentation skills for both clinical and non-clinical audiences

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
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 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.
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.
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.
The CMO maintains a strong 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.