DSNP Executive Director, Missouri and Iowa - Remote in MO, IA or surrounding area

About the role

The Executive Director, Dual Special Needs Plan (DSNP ED) manages a complex, innovative, and growing product line in collaboration with local Market Medicaid leadership and our nationally leading Medicaid team. The role focuses on delivering overall product results, including growth, medical expense and revenue management, quality and clinical outcomes, and integration and coordination of Medicaid and Medicare benefits.

Responsibilities

• Direct oversight of the Dual Special Needs Plan (D-SNP) for multiple states

• Ensures compliance with applicable state and Federal laws and with contractual obligations to state Medicaid, providers and others

• Product P&L ownership and matrixed and direct leadership across a complex organization

• Inclusive of end-to-end ownership of all related functions for assigned D-SNP markets including:

  • The development of market specific State Medicaid Agency Contract (SMAC) agreements and accountability for ensuring compliance with SMAC requirements

  • Collaboration with Government Programs functional teams including but not limited to Product, Stars, Operations, Clinical, Sales and Marketing to ensure best in class delivery of Medicare Advantage programs

  • Identification of market specific requirements and alignment with national vendor (clinical/non-clinical) options to support cost effective, proven solutions

  • Maintain awareness of and apply emerging state and federal policy requirements to market specific strategies

• Leading medical expense management strategies to address emerging trends, collaborating with national Quality team members to drive continual STAR Rating performance, and leading with a Person-First mindset to ensure our Medicaid and Medicare programs fully support our membership across all domains of care

• Fostering close, mutually beneficial relationships with local community supports and providers, including but not limited to primary care medical homes, health systems, behavioral health providers, community leaders, community-based organizations, policymakers and consumer advocacy groups throughout the states

• As a key leader among the health plans, assures that the health plans and their partners live up to service commitments for the communities served

Requirements

• 4+ years of experience in Medicaid and/or Medicare programs environment, care delivery models, VBC/APMs

• Experience in quality improvement, strategic planning and development

• Experience designing and/or administering health programs and developing health care policy

• Experience managing high-profile community projects or large-scale contracts

• Consistent, progressive leadership experience in health care delivery and public programs

• In-depth knowledge of the dual Medicaid - Medicare eligible populations including Behavioral Health and LTSS

• People management, including direct supervisory experience and ability to indirectly influence those outside of direct supervision

• Resident of Missouri, Iowa, surrounding states or willing to relocate

• Ability to travel up to 75%

Preferred Qualifications

• Knowledge of and experience with the Medicaid waiver process

• Knowledge of and experience with Medicaid and Human Services systems within the served states, licensure processes, quality and financial oversight processes, including applicable federal and state regulations

• Knowledge of and experience with the Medicaid waiver process

• Knowledge of and experience with Medicaid and Human Services systems within the served states, licensure processes, quality and financial oversight processes, including applicable federal and state regulations

Benefits

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.