Executive Director, Clinical Transformation and Delivery – Strategic Leadership for Medicaid and Medicare Population Health Management

Introduction to UnitedHealthcare

At UnitedHealthcare, we are dedicated to simplifying the healthcare experience, creating healthier communities, and removing barriers to quality care. Our mission is to help people live healthier lives and make the healthcare system more responsive, affordable, and equitable. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes. As a leader in the healthcare industry, we are seeking a highly skilled and experienced Executive Director, Clinical Transformation and Delivery to join our team and drive success in our Medicaid and Medicare population health management initiatives.

Job Overview

The Executive Director, Clinical Transformation and Delivery provides strategic leadership, direction, and oversight of all clinical programs for Medicaid and Medicare membership served by the Tennessee Community and State Health Plan. This leader will provide innovative thought leadership to the design, implementation, and delivery of various care programs to make a positive impact on the lives of Tennesseans. The successful candidate will have a strong and diverse skillset in relevant areas, including clinical transformation, population health management, and value-based care.

Key Responsibilities

• Provide strategic leadership and direction for the design, deployment, implementation, and management of integrated clinical programs that optimize clinical and health outcomes for Medicaid and Medicare recipients
• Develop and implement innovative clinical strategies and programs for Medicaid and Medicare populations, including physical health, behavioral health, and social determinants of health (SDOH) services
• Collaborate with external and internal business partners, including the Bureau of TennCare, UHC-Clinical Services, Appeals and Grievance, Quality, Provider Network, Optum case and disease management, and other clinical specialty vendors and stakeholders
• Ensure achievement of state quality initiatives, HEDIS measures, and compliance with relevant requirements of the state's annual Performance Review(s) conducted by the External Quality Review Organization (EQRO), state or other oversight body, and meeting NCQA requirements
• Lead health plan clinical teams, including Population Health, Quality, Case Management, Community Outreach, SDOH, and Value-Based Provider Engagement staff, to execute against strategic, tactical, and operational goals
• Develop and lead multi-level leaders and provide guidance, development, and training to leadership staff at various levels
• Represent UnitedHealthcare and serve as a Thought Leader via "Outside of the Box" thinking when collaborating with State customers on member/provider engagement and improved health outcome initiatives

Essential Qualifications

• 7 years of healthcare management experience in a business, managed care, or payer health plan setting
• 5 years of demonstrated progressive career accomplishments as a seasoned leader
• 5 years of experience developing and implementing innovative clinical strategies and programs for Medicaid and/or Medicare populations
• Proven experience working in a cross-functional environment and well-developed relationship-building skills, willing to take a leadership role driving initiatives, working across organizations, and structuring approaches to new opportunities
• Experience establishing and maintaining effective working relationships with employees, managers, healthcare professionals, physicians, executive leaders, and market leaders
• Proven ability to develop and lead multi-level leaders and quickly diagnose and solve complex problems
• Proven excellent influencing, negotiating, planning, and decision-making skills
• Demonstrated ability to lead business initiatives to a successful result and effectively deal with ambiguity, change, and uncertainty

Preferred Qualifications

• Master's degree in Healthcare Administration, Business Administration, or a related field
• Experience working in a matrixed organization and leading large, cross-functional teams
• Knowledge of Medicaid and Medicare regulations, policies, and procedures
• Experience with value-based care models, population health management, and quality improvement initiatives
• Strong analytical and problem-solving skills, with the ability to analyze complex data and develop innovative solutions

Career Growth Opportunities and Learning Benefits

At UnitedHealthcare, we are committed to helping our employees grow and develop in their careers. As an Executive Director, Clinical Transformation and Delivery, you will have the opportunity to work with a talented team of professionals, develop your leadership skills, and contribute to the development and execution of innovative clinical strategies and programs. You will also have access to a range of training and development programs, including leadership development, clinical education, and professional certification opportunities.

Work Environment and Company Culture

UnitedHealthcare is a dynamic and fast-paced organization that values innovation, collaboration, and diversity. Our company culture is built on a foundation of integrity, compassion, and a commitment to excellence. We believe in creating a work environment that is inclusive, supportive, and empowering, where employees can thrive and grow in their careers. As an Executive Director, Clinical Transformation and Delivery, you will be part of a team that is dedicated to making a positive impact on the lives of our members and the communities we serve.

Compensation, Perks, and Benefits

The salary range for this role is $150,200 to $288,500 annually, based on full-time employment. In addition to your salary, you will be eligible for a range of benefits, including a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution. You will also have access to a range of perks, including flexible working arrangements, professional development opportunities, and a dynamic and supportive work environment.

Conclusion

If you are a motivated and experienced healthcare professional looking for a challenging and rewarding role, we encourage you to apply for the Executive Director, Clinical Transformation and Delivery position. This is a unique opportunity to join a talented team of professionals, develop your leadership skills, and contribute to the development and execution of innovative clinical strategies and programs. Don't miss out on this chance to make a positive impact on the lives of our members and the communities we serve. Apply today!

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