Director, C&S Clinical Programs Development and Operations - West Region - Remote - Las Vegas Nevada

Company: UnitedHealth Group
Location: Las Vegas, Nevada
Posted On: 01/16/2025

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.United Healthcare Community & State is looking to hire a Director, Clinical Program Development and Operations (West Region). This position will report to the Sr. Director, Medicaid Clinical Program Development and Operations of the West Region. This is remote and can be based anywhere in the US, with the ability to travel up to 25% to support our regional plans. -You'll enjoy the flexibility to work remotely * from anywhere within the U.S. (west region preferred) as you take on some tough challenges. -Primary Responsibilities:Own the end-to-end development and execution of clinical strategy and programs for several of the most complex markets in their RegionPartner with CEOs, CMOs, and HSDs in their markets to design and manage a customized portfolio of clinical programs and capabilities that meet their markets' needs including maternity, youth/adolescent, behavioral health, care management, chronic disease and preventative healthDrive new clinical program implementation and provide ongoing clinical operations support within a population health and health equity framework for their marketsDevelop relationships with their market clinical leaders and an understanding of the unique dynamics and state requirements in their marketsSupport markets in responding to new contractual requirements for clinical programs including developing and implementing new clinical programs that meet these contractual requirements and drive quality outcomes -Identify clinical programs from the national clinical portfolio that can support state priorities in their markets and customize these programs to the unique needs of each marketServe as the accountable Clinical leader and single point of contact for any clinical needs or issues their market has and either solving problems or bringing in the appropriate national SME who can solve the problemOwn the design and management of the national core clinical programs and vendors for a priority area such as maternal and child health, behavioral health/OUD/SUD, or chronic disease and preventative healthServe as a clinical SME supporting any market in designing and implementing a new clinical program in their area of expertiseOwn the continuous evaluation of the clinical programs and vendors in their area of expertise including driving evaluations and sharing data on ROI and clinical outcomes with market clinical leadersPrimary Market Clinical Support Responsibilities: -Develop and manage a differentiated portfolio of clinical programs and capabilities that achieve the highest quality outcomes for the markets in their regionCustomize national clinical capabilities for state-specific needs in partnership with the health plan clinical leaders in their markets to meet new clinical requirements or help achieve growth or quality goalsDevelop new state-specific clinical program when no national solution exists including using data on the population, designing and operationalizing the program in partnership with the health plan, and measuring the resultsReview performance of current clinical programs in their markets based on quality outcomes, member experience and ROI and identify opportunities to improve and evolve programs for their marketsManage program portfolio for each of their markets to improve competitive position and optimal performance -Ensure the market teams have the clinical tools and resources available to meet/exceed all goals -Primary National Clinical Responsibilities: -Oversee and manage the national core clinical programs and vendors for a priority area such as maternal and child health, behavioral health/OUD/SUD, or chronic disease and preventative healthSupport markets that have a requirement for a new clinical program in their area of expertise with designing and executing a program that meets and exceeds all state requirementsSupport markets with implementing a national vendor in their area of expertise including supporting the contract development and ensuring the vendor can meet all state specific requirementsPartner with HCE on the evaluation of the clinical programs and vendors in their area of expertiseShare data on ROI and clinical outcomes for vendors in their area of expertise with market clinical leadersYou'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.Required Qualifications:4+ years of experience in Medicaid and working in a matrix organization -4+ years of experience leading and/or managing people -4+ years of experience designing and implementing clinical/quality programs in a Medicaid health plan environment or equivalent experience -Proven experience developing and implementing comprehensive clinical programs aligned with organizational goals and strategies -Proven experience conducting needs assessments to identify gaps in service delivery -Proven experience collaborating with clinical leaders and stakeholders to design effective program modelsExperience driving quality results through setting clear goals, managing accountability and performance management for individuals and teams -Solid clinical and technology acumen and have experience with strategic and tactical level executionClinical management experience within a managed care environment -Ability to successfully work in a matrix management environment, with a proven track record of building and maintaining effective internal partnerships that lead to external client satisfaction -Solid negotiation, problem solving, planning and decision-making skills -Solid demonstrated ability to lead business initiatives to a successful outcome -Solid communicator; capable of effectively presenting ideas and selling concepts and tactics; excellent writer, proven ability to communicate effectively with executives; ability to quickly understand needs and act on those needs; ability to conceptualize and effectuate change management and "out-of-the-box" thinking -Proven cross-functional influence and well-developed relationship building skills, willing to take a leadership role driving initiatives, working across organizations and structuring approaches to new opportunities -Ability to effectively deal with ambiguity - can effectively cope with change, can shift gears comfortably, can decide and act without having the total picture, comfortably handles risk and uncertainty in a manner consistent with UnitedHealth Group's core values -Access to high-speed internet -Ability to work within the time zone aligned to support the regional health plan -Ability to travel up to 25% within the U.S. -Preferred Qualifications:RN, LCSW, or LPN/LVN license and 5+ years of experience in a related field preferred, including clinical or quality experience in a managed care setting; or any combination of education and experience, which would provide an equivalent background -5+ years of Medicaid experience preferred and experience designing and implementing clinical/quality programs in a Medicaid health plan environment or equivalent experience -*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyThe salary range for this role is $124,500 to $239,400 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.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.At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. -Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. - - -UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.Brand: Community & StateJob ID: 2265691Employment Type: Full-timeJob Area: ClinicalFunction: Clinical ResearchIndustry: Direct Health/Medical Insurance Carrier More...

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