E&I Market Chief Medical Officer MN/WI

Clinical Affordability

• Drive savings through targeted clinical interventions addressing local market trends and needs
• Support national utilization management programs
• Apply healthcare economics insights to escalate local issues and trends
• Inform and drive local and national affordability initiatives

Network / Provider Engagement

• Meet regularly with hospitals and physician groups
• Share data on quality and efficiency improvement opportunities and develop action plans
• Engage in value-based contracting, clinical practice transformation, and patient-centered medical homes
• Participate in transparency initiatives such as UnitedHealth Premium® Designation and/or High Performing Physicians

Market Relationships

• Engage in regular, proactive dialogue with elected officials, policy makers, plan sponsors, medical and professional societies, news media, and community-based organizations
• Advocate for UnitedHealthcare's clinical value story, evidence-based medical policies, and member health
• Communicate with government/state regulatory entities, professional and medical society chapters, employers, and external communications and media relations

Quality & Compliance

• Maintain a strong working knowledge of all government mandates and provisions
• Work across the enterprise to implement and maintain compliant clinical programs and procedures
• Support quality improvement efforts as measured by CMS Star Ratings, NCQA Star Ratings, HEDIS, CAHPS, HOS and other national and company metrics
• Partner with UHC Compliance to ensure clinical management regulatory obligations are met
• Chair required Quality Oversight Committees at a market/regional level

Required Qualifications

• 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
• Prior health plan experience in similar leadership capacity
• Advanced Business, Public Health, Medical Management degree
• 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% travel required
• Proficiency with Microsoft Office applications (Outlook, Word, Excel, PowerPoint)
• Capable to quickly become facile with UHC/UHG specific data systems

Preferred Qualifications

• 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

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

Pay

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).

Application Deadline

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.