National Medical Director, Cardiovascular Health - UHC

UnitedHealth Group•Minnetonka, MN

1d•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. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The National Medical Director of Cardiovascular Health is responsible for leading the design, development and oversight of clinical specialty programs to improve the affordability and quality of medical care across the continuum of cardiovascular medical management, diagnostic and monitoring procedures, minimally invasive and surgical procedures and device-based therapies. The National Medical Director leads a small entrepreneurial team that uses the company’s health care analytical tools, medical literature, clinical experience, and provider and member feedback to identify, design and implement clinical programs to lower cost, simplify healthcare delivery and improve quality and outcomes. The team is also accountable for post-deployment review of results. This position reports to the National Medical Director of Specialty Content and Care Pathways in UnitedHealthcare Clinical Services. This role requires a strategic and critical thinking mindset with the ability to handle multiple priorities as well as the ability to articulate and represent UHC clinical strategy to executive leaders across the enterprise and to external stakeholders. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires within 30 minutes of an office in Minnesota or Washington, D.C., you'll be required to work a minimum of four days per week in-office. 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.

Requirements

Doctorate of Medicine (MD or DO) degree with active/unrestricted medical license in one of more states
Trained and board certified in Cardiovascular disease or Thoracic and Cardiac Surgery, or related specialty/subspecialty required
10+ years of clinical practice experience required
7+ years of progressive healthcare leadership experience managing clinical and cross functional teams
5+ years of senior level management experience leading clinical operations in a health plan or managed care environment
Business training and experience in addition to clinical expertise
Demonstrated understanding of and experience with managed care functions of utilization management, clinical decision support, post service review, and/or care management functions aligned to evidence-based medicine
Demonstrated ability to read and understand evidence-based medical literature and how this applies to the development of medical policy and clinical guidelines
Familiarity with digital health platforms and healthcare data exchange
Solid strategic thinking and business acumen with the ability to align clinical related strategies and recommendations with business objectives
Solid analytic and critical thinking skills with proven ability to use clinical, quality and claims data to identify opportunities, inform program design and measure process, clinical and financial outcomes
Solid history of quickly building relationships, gaining credibility, and partnering with business leaders
Solid operational focus with demonstrated data analysis / interpretation acumen, project management, change management, and execution skills
Solid organizational, management, administrative, and human relations skills, and a style which exhibits emotional maturity, leadership, collaboration, and teamwork
Proven ability to communicate effectively and efficiently (both verbally and written) at multiple levels of large, complex organizations
Proven ability to drive, lead and to communicate change effectively in a fast-paced environment and be adaptable within the changing environment
Proven ability to motivate, mentor, and influence others at all levels within the organization
Demonstrated ability to make strategic, operational, and administrative decisions in response to emerging conditions and environmental circumstances
Demonstrated ability in systems thinking and enterprise insight to solve complex business problems and solid analytical skills with ability to drive transformational, consumer-centric change and manage long-term programs
Past success working collaboratively in a highly matrixed environment

Nice To Haves

Experience in digital health transformation or technology-enabled care models

Responsibilities

Clinical Strategy Leadership in Program Design and Development
Possess solid clinical and operational knowledge having worked in the designated medical specialty of Cardiology, Interventional Cardiology, or Cardiothoracic Surgery
Oversee the strategy for health plan cardiolovascular specialty programs using knowledge and understanding of the healthcare industry, emerging technology and trends, and current medical specialty guidelines and peer-reviewed literature, incorporating feedback from key stakeholders
Lead the design of clinical program development for modernizing utilization management and retrospective clinical review programs across the continuum of diagnostic evaluation and medical management of cardiovascular conditions and procedures and surgeries to improve health outcomes with a focus on member and provider experience
Provide leadership and clinical insights for cardiovascular category activities across the enterprise such as value-based care programs, quality improvement initiatives, and care management
Process Optimization
Identify pain points in current prior authorization processes and propose innovative solutions
Support effective implementation in partnership with teams in clinical operations and technology
Participate in the development of pilot programs and evaluate performance metrics for automation initiatives
Build and develop relationships across teams to ensure effective feedback loops and that deliverables are met
Set and review program metrics for continuous enhancements, updates, and improvement
Data and Technology Proficiency
Assess and interpret complex financial and clinical data to evaluate feasibility of proposed initiatives
Direct the healthcare analytics team as they work through hypothesis and problems and synthesize the results and to assure model assumptions are accurate
Evaluate clinical, quality and claims data to identify opportunities for improvement of clinical programs
Provide clinical insights and input to guide technology partners in development of large language learning models and technical capabilities for care pathways and bundled authorizations
Communication, Collaboration and Relationship Building
Articulate and represent UHC clinical strategy to executive leaders across the enterprise and to external stakeholders and be able to speak clearly on complex problems
Advocate with leadership across the organization to create better alignment with business segments, network, and functional areas, thereby ensuring internal and external coordination and a unified approach to the market and associated constituents
Coordinate efforts of clinical, network, operations and healthcare economics teams to support expansion of value-based programs delivered through our providers
Create and maintain solid relationships with key clinical leaders across the organization
Clinical Expertise
Collaborate with the CMO, clinical, network and business leaders on top priorities and goals
Participate in key clinical committees
Solicit or respond to input on clinical initiatives
Influence development of clinical communications that will be delivered to external audiences. (e.g., new clinical policies, programs, processes)
Participate in the response development and delivery to high level questions, concerns and complaints from regulators, accreditors, legal/risk management, employers, healthcare providers, and other stakeholders
Discuss clinical program outcomes, data and performance with providers, employers, accreditors and regulators