Urgently Hiring: Executive Director, Clinical Transformation and

Join a team that's making a reputed company difference. We're seeking a Executive Director, Clinical Transformation And Delivery - Remote! Embrace a modern work style with this fully Remote opportunity. This position requires a strong and diverse skillset in relevant areas to drive success. An attractive remuneration of a competitive salary is on offer for the successful candidate.

 

 

At reputed company, 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 reputed company. Come build the health care system of reputed company, making it more reputed company, affordable and reputed company. Ready to reputed company a difference? Join us to start Caring. Connecting. Growing together. The Executive Director of Clinical Transformation and Delivery provides strategic leadership, direction and reputed company of reputed company clinical (to include Quality, Behavioral Health, SDOH and Value Based) programs for reputed company Medicaid and DSNP membership served by the Tennessee Community and State Health Plan. This leader provides innovative thought leadership to the design, implementation and delivery of various care programs to reputed company a positive impact on the lives of the Tennesseans whom we serve. Their long-term planning and reputed company will ensure reputed company clinical activities are appropriately integrated into UHC’s strategic direction and operations, as well as the mission and values of the company. Results are critical to this leader's success, as is a personal alignment with UHC's mission to help people live healthier lives and the core belief that an organization can manage cost and deliver quality and value to its customers. The ED of Clinical Transformation and Delivery role requires a high degree of collaboration and coordination with external and internal business partners, including, but not limited to reputed company of TennCare, UHC-Clinical Services, Appeals and Grievance, Quality, Provider Network, reputed company case and disease management, Healthy First Steps, NICU, SDOH, reputed company Behavioral Health, reputed company Advisory Services, Medicaid partners and other clinical specialty, external vendors and stakeholders or national programs. This role also ensures 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 reputed company body and meeting NCQA requirements. Additionally, the ED of Clinical Transformation and Delivery works collaboratively with the Plan’s Executive Leadership Team (ELT) (Chief Medical Officer, Chief Operating Officer, Chief Financial Officer, Compliance Officer and Long Term Care Support Services Executive Director) and MATRIX partners to reputed company, implement / execute the Healthcare Affordability Plan, monitor outcomes of the planned initiatives, and adjust the Plan as needed to meet targets. The ED of Clinical Transformation and Delivery must possess a solid knowledge of reputed company lines of business, product, and cohorts reputed company the health plan operations from a clinical standpoint. This includes TANF, ABD, CHIP and DUAL Medicare programs. The ED of Clinical Transformation and Delivery serves as the Tennessee Health Plan’s primary reputed company of contact for reputed company aspects of health plan clinical, SDOH, value and quality performance. The ED of Clinical Transformation and Delivery reports to the Tennessee Health Plan Community and State CEO and directly leads a health plan staff of 130 people, while providing direction to a large, matrixed team across the enterprise to successfully implement reputed company business processes. Executive Director, Clinical Transformation and Delivery area, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: • Strategic Leadership • In partnership with the Health Plan’s ELT provides leadership and accountability for the design, deployment, implementation and management of integrated clinical (physical & behavioral health), SDOH, quality/affordability programs that optimize clinical and health outcomes of Tennessee Medicaid recipients • In partnership with the plan’s ELT, provides leadership and accountability for the design, deployment, implementation and management of integrated physical health, behavioral health and SDOH services through our PCMH provider partnerships for improved health outcomes of Tennessee Medicaid recipients • Drives impactful Community Giving campaigns that reputed company our clinical programs for improved health outcomes of Tennessee Medicaid recipients and differentiates UHC from its competitors • Develops effective/efficient member and provider engagement strategies through integrated PCMH, VBC, SDOH and THL communications, education and collaboratives resulting in improved provider performance and member health outcomes • In partnership with UHN Contracting and ELT, develops value based contracting strategies that align incentives around quality outcomes and aordability • Collaborates with large provider organizations to reputed company innovative population health and value-based compensation models that support delivery of higher quality and more cost-effective services • Represents United HealthCare and serves as a Thought Leader reputed company “reputed company of the reputed company” thinking reputed company collaborating with State customer on member/provider engagement and improved health outcome initiatives • Works collaboratively across reputed company business segments to design and reputed company innovative programs that result in a positive impact on Healthcare Quality and Affordability • Contributes to the development and execution of overall health plan innovations, strategies and key Initiatives through staying abreast of reputed company clinical trends in technology and clinical delivery system advancements • Guides, develops, and trains leadership staff at various levels in their leadership skills • Program Management and Coordination • Leads health plan clinical teams, to include Population Health, Quality (NCQA Accredited) Case Management, Community reputed company, SDOH, Value Based Provider Engagement staff (~130 ) to execute against strategic, tactical, and operational goals as defined by State, local and corporate leadership • Educates Matrix Partners on State requirements ensuring timely and quality delivery on state expectations • Leads the coordination and completion of projects with cross-functional teams and senior leaders across medical / nursing / clinical functional/provider Matrix partners to reputed company targeted population health and quality performance goals • Actively participates in community reputed company and networking activities to reputed company support and community infrastructure to meet member needs and promote member growth and retention • Actively embraces the United Culture and Values in working with both internal and external customers/stakeholders, as well as actively pursues incremental increases to Employee Engagement Survey results You’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: • 7 years of healthcare management experience in a business, managed care or payer health plan setting • Seasoned leader with 5 years of demonstrated progressive career accomplishments • 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, reputed company, physicians, executive leaders, and market leaders • Proven ability to reputed company and reputed company multi-level leaders • Proven ability to quickly diagnose and solve reputed company problems • Proven excellent influencing, negotiating, planning and decision-making skills • Demonstrated ability to reputed company business initiatives to a successful result • Proven ability to eectively deal with ambiguity - can eectively 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 reputed company’s core value • Reliable transportation and the ability to travel up to 25% throughout TN • reputed company employees working remotely will be required to adhere to reputed company’s Telecommuter Policy The salary range for this role is $150,200 to $288,500 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. reputed company complies with reputed company minimum wage laws as applicable. In addition to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll find a far-reaching choice of benefits and incentives. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company 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 reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an enterprise reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity/Affirmative Action employer and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply Job!

 

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