Director, Medicaid Population Health & Quality

UnitedHealth Group; Wisconsin; Remote; USD 159,000 - 273,000; Full time

Job summary

UnitedHealth Group in Milwaukee, WI is seeking a Health Services, Population Health & Quality Director to provide strategic leadership for Health Services, Care Management, Utilization Management, and Clinical Quality for Wisconsin Medicaid programs. The role aims to drive clinical excellence and improve population health outcomes across multiple programs and populations.

You will lead multidisciplinary clinical teams, set departmental goals, monitor performance, and ensure compliance with state

Qualifications

• 8+ years of health plan or managed care experience.
• 5+ years of Medicaid managed care experience.
• 5+ years of leadership experience managing clinical and non-clinical staff.
• 5+ years of clinical practice experience in a hospital, clinic, home health, nursing facility, or related healthcare setting.
• Experience in Care Management, Case Management, Disease Management, and/or Utilization Management.
• Experience leading quality improvement programs and healthcare quality initiatives.

Responsibilities

• Provide strategic leadership and oversight for Health Services functions including Care Management, Disease Management, Utilization Management, and Transition of Care programs.
• Lead and develop multidisciplinary clinical teams, ensuring effective performance, engagement, and professional development.
• Establish departmental goals, monitor performance outcomes, and drive continuous improvement initiatives.
• Ensure clinical programs support the health and well-being of statewide Medicaid membership across multiple programs and populations.
• Collaborate with operational and clinical leaders to align health services strategies with organizational priorities and contractual requirements.
• Drive initiatives that improve member experience, access to care, care coordination, quality outcomes, and health equity.
• Provide overall leadership for the health plan's Quality Management Program and Quality Improvement Program.
• Develop and execute comprehensive quality strategies aligned with state, federal, NCQA, and organizational requirements.
• Oversee the development, implementation, monitoring, and evaluation of annual quality work plans and performance improvement initiatives.
• Ensure compliance with Medicaid contractual requirements, state and federal regulations, NCQA standards, and accreditation requirements.

Skills

Leadership

Quality improvement

Population health

Education

Bachelor's degree in Nursing, Healthcare Administration, Public Health, or related field

Job description

UnitedHealth Group in Milwaukee, WI is seeking a Health Services, Population Health & Quality Director to provide strategic leadership for Health Services, Care Management, Utilization Management, and Clinical Quality for Wisconsin Medicaid programs. The role aims to drive clinical excellence and improve population health outcomes across multiple programs and populations.

You will lead multidisciplinary clinical teams, set departmental goals, monitor performance, and ensure compliance with state