Executive Director, C&S VA - Remote in VA, WV or MD - 2287490

UnitedHealth Group; Richmond (VA); Remote; Confidential; Full time

Job summary

A leading healthcare organization is seeking an Executive Director to oversee clinical programs and business strategies impacting Medicare Advantage populations. This role requires strong leadership to drive initiatives aimed at quality care, member retention, and strategic growth within the Virginia, Maryland, and West Virginia markets. The ideal candidate will bring extensive experience in managed care, creativity in problem-solving, and the ability to foster partnerships with key stakeholders.

Benefits

Comprehensive benefits package

Incentive and recognition programs

401k contribution

Equity stock purchase

Qualifications

• 8+ years in healthcare/managed care with increasing responsibility.
• 5+ years managing teams with direct reports.
• In-depth knowledge of CMS Star ratings and HEDIS measures.

Responsibilities

• Defines and executes Provider Engagement and Growth strategies.
• Leads initiatives to achieve high Star ratings in Medicare Advantage.
• Collaborates cross-organizationally to drive plans aligned with P&L.

Skills

Financial acumen

Analytical skills

Leadership

Relationship building

Communication

Job description

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.

The Executive Director is responsible for the management of multiple clinical programs and business development opportunities impacting Medicare Advantage populations within VA, MD, and WV states.

The Medicare & Retirement Executive Director is accountable for all aspects of the P&L within a given market, with primary responsibility for defining, leading and driving local initiatives to achieve five Star CMS rating, Coding, Growth, Building Medicare networks, Retention of Medicare members and Affordability goals. The Executive Director sets strategy and prioritization with national shared service partners specific to the local market and ensures cross-organizational alignment. Is the face of M&R in his/her market. Establishes and maintains clear leadership credibility and partnership with our external provider and broker partners. Recruits, retains and nurtures top talent. Promotes Our United Culture. Drives innovation. Is externally focused and facing. Additionally, this role will be responsible for identifying and leading new business strategies and initiatives to meet the needs of our members. These strategies will impact Medicare Advantage product development and planning, new business ventures, and market expansion.

Must be willing to travel 25% of your time within the states of VA/MD/WV market area.

If you are located in Virginia, Maryland, West Virginia market area, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Defines and owns execution of the Provider Engagement strategy; establishes solid, collaborative relationships with providers in support of all Quality, NPS and Affordability goals; works collaboratively with Optum, UHN and UCS partners
• Defines and owns execution of the Growth and Retention strategy in partnership with Distribution; is the face of the market to external channels
• Defines and owns execution of the Stars strategy inclusive of HEDIS, Part D and CAHPS to achieve 80% of members in 4+ star plans
• Stars strategy inclusive of HEDIS, Part D and CAHPs to achieve 85% of members in 4 star plans
• Must be able to demonstrated ability of 5+ years of experience in Medicare with a concentration on Stars market leading levels at 4+ stars
• Working cross-organizationally with local health plan team, Network, Market Medical Director and Optum to increase suspect closure, recapture, and prevalence improvement inclusive of increasing HouseCalls completion rates and reducing refusal rates
• Achieving market-level NPS goals
• Identifying and executing against Affordability opportunities aligned with market goals
• Act as voice of the market for print and television interviews
• Actively collaborates with all Medicare & Retirement national functions (Product, Sales, Marketing, Member Experience, Finance), UnitedHealthcare shared services functions (Network, Clinical, Quality, Operations) and Optum (Local Care Delivery, HouseCalls, Complex Population Management) functions to leverage local market knowledge and establish and drive plans across all levers of the P&L

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:

• 8+ years of experience in a large, complex, and successful health care / managed care organization with demonstrated track record of increasing responsibility and accountability
• 5+ years as a manager with direct reports who drives performance
• In-depth experience with health care providers/ networks, CMS Star ratings, HEDIS measures, Part D and clinical quality
• Demonstrated success building relationships with external executives and stakeholders
• Demonstrated solid financial acumen and analytical skills
• Reside in VA/MD/WV market areas or willing to relocate
• Driver’s License and access to a reliable transportation
• Ability to travel up to 25% within the VA area

Preferred Qualifications:

• 5+ years of experience in Medicare provider contracting including demonstration of contracting with hospital CEOs/CFOs
• 3+ years of proven experience with Medicare Advantage filing of bids and creation of benefit packages that will lead to double digit growth and high member NPS scores
• Experience in a Medicare Advantage or other government-funded healthcare business
• Proven solid written and verbal communication skills, including well-developed interpersonal skills used to influence the behavior of others across a highly-matrixed organization
• Proven track record of meeting business goals via driving disciplined, fact-based decisions and executing with discipline and urgency
• Proven organizational skills with ability to be flexible and work with ambiguity
• Demonstrated excellent communication skills - ability to speak to large groups and television interviews as well

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

The 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 all 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.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.