Vacancy caducado!
Looking for a chance to drive measurable and meaningful improvement in the use of evidence-based medicine, patient safety, practice variation and affordability? You can make a difference at UnitedHealth Group and our family of businesses in serving our Medicare, Medicaid and commercial members and plan sponsors. Be part of changing the way health care is delivered while working with a Fortune 5 industry leader.The medical director/CMO is actively involved in all major clinical functions, health programs and quality management components of UnitedHealthcare’s operations, including the Medically Frail portion of Kentucky HEALTH. The medical director/CMO oversees clinical operations initiatives that focus on clinical excellence, affordability and performance improvement. She/he oversees the development, implementation and review of quality improvement and quality of care (i.e., Internal Quality Assurance Plan), including implementation of and adherence to corrective action plans (CAPs). She/he is responsible for treatment policies, protocols, quality improvement activities, population health management activities and utilization management (UM) decision oversight, and for ensuring timely medical decisions. She/he is responsible for developing and implementing UM, disease management and quality management strategies to serve our enrollees. The medical director also oversees clinical directors, including those employed by subcontractors. The Medical director is responsible for driving clinical outcomes, whole person care and population health program performance and achieving medical loss ratio objectives for the health plan while ensuing members receive the right care in the right service setting. The scope of the role will include 7 direct and 2 indirect reports spanning the scope of quality, clinical, dental, opioid use disorder/substance use disorder, program, pharmacy and psychiatry/behavioral health.Required Qualifications:
A Board-certified medical physician with an active license in Kentucky
Experience with Medicaid and Dual Eligible members
3 + years of training in a medical specialty and 5 years of experience post-training providing clinical services
Previous successful experience leading disease management/quality improvement/care management program activities at a health system, large safety-net provider, or managed care plan with demonstrated outcomes and available for after-hours consultation
Must reside in, or be willing to relocate to, the Commonwealth of Kentucky
Preferred Qualifications :
Background in internal medicine, pediatrics, obstetrics/gynecology, family medicine, or geriatrics
Experience with integration of care for dual-eligible enrollees
Experience managing a matrix environment
Experience in a managed care organization
Experience managing staff
Previous work with care coordinators, including review of care plans
Experience with substance use disorder/opioid use disorder treatment programs or public health initiatives
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work. SMDiversity 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.Job Keywords: CMO, UHC Comm, Plan of KY, Kentucky, Chief Medical Officer
Vacancy caducado!