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UnitedHealthcare Market Medical Officer - Employer and Individual - GA/AL - Hybrid job in Atlanta at UnitedHealth Group

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UnitedHealthcare Market Medical Officer - Employer and Individual - GA/AL - Hybrid at UnitedHealth Group

UnitedHealthcare Market Medical Officer - Employer and Individual - GA/AL - Hybrid

UnitedHealth Group Atlanta, GA (Remote) Full-Time

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 and start doing your life's best work.(sm)

If you are located in Georgia or Alabama, you will have the flexibility to work remotely* as you take on some tough challenges. 

Primary Responsibilities:

  • UnitedHealthcare’s Market CMOs serve as the local senior clinical executive for their line of business, with accountability for:
  • Achieving defined clinical outcomes, affordability goals and growth targets, in partnership with their health plan leadership team
  • Provide clinical insight into market data and implementing tailored interventions to address clinical trends and opportunities for their state or region
  • Serving as a central health plan leader accountable to facilitate coordination with UnitedHealthcare and Optum national clinical and operational functions
  • Actively engage and help drive performance with market-level quality, network, and compliance teams
  • Building and deepening relationships with area hospitals, physicians, and other health care providers
  • Advocate for UnitedHealthcare’s clinical value story, evidence-based medical policies, and member health with government/state regulatory entities, professional and medical society chapters, employers, and as part of external communications and media relationsa
  • Provides subject/specialty based clinical expertise and leadership to UCS and the enterprise, as needed

Primary Core Accountabilities

  • Clinical Affordability - CMOs are responsible for achieving their assigned incremental savings goal and support the national savings target for the year. Driving savings is a two-pronged, data-driven approach of local response and national implementation. The CMO serves as the market lead over all clinical programs impacting a member’s passage from enrollment thru end-of-life care by leading targeted clinical inventions to address local market needs and aligning with national initiatives.  CMOs are expected to apply healthcare economics insights and escalate local issues and trends
  • Network / Provider Engagement - The CMO serves as the local clinical point of contact for physicians, systems, and other care providers and with UnitedHealth Networks colleagues. Key activities include UHC’s Accountable Care Platform, value-based contracting, clinical practice transformation, patient-centered medical homes, and transparency initiatives such as UnitedHealth Premium® Designation and/or High Performing Physicians. The CMO meets regularly with hospitals and physician groups and shares data on quality and efficiency improvement opportunities and develops action plans for optimal results
  • Market Relationships - The CMO is the clinical face of UnitedHealthcare to elected officials, policy makers, plan sponsors, medical and professional societies, news media, and community-based organizations. The CMO is engaged in regular, proactive dialogue with our external constituents to advance evidence-based medicine and support best practices in health care delivery
  • Quality & Compliance - The CMO maintains a solid working knowledge of all government mandates and provisions, working across the enterprise to implement and maintain compliant clinical programs and procedures.  The CMO also supports quality improvement efforts as measured by CMS Star Ratings, NCQA Star Ratings, HEDIS, CAHPS, HOS and other national and company metrics. The CMO partners with UHC Compliance to ensure clinical management regulatory obligations regarding clinical management are met. Market CMOs also chair required Quality Oversight Committees at a market/regional level

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:

  • Active and unrestricted Georgia/Alabama Medical License 
  • Reside in, or be willing to relocate to assigned market (Note telecommuting is an option but you are required to be within commuting distance of Atlanta, GA office)
  • Board Certified in an ABMS or AOBMS specialty 
  • 5+ years clinical practice experience
  • Solid knowledge of managed care industry
  • Familiarity with current medical issues and practices 
  • Ability/experience in developing collaborative relationships with health system clinical leadership  
  • Solid knowledge of health care utilization data and analytics
  • Proficiency with Microsoft Office applications (Outlook, Word, Excel, PowerPoint)
  • Capable to quickly become facile with UHC/UHG specific data systems
  • Proven ability to identify an improvement opportunity through data, implement a solution and achieve measurable impact. Solid data analysis and interpretation skills; KPI metrics driven
  • Ability to travel within the assigned market-up to 30% travel 
  • Reside in, or be willing to relocate to assigned market (Note telecommuting is an option but you are required to be within commuting distance of the office)
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

  • Advanced Business, Public Health, Medical Management degree
  • Health plan experience in similar leadership capacity
  • Knowledge of Georgia/Alabama hospitals and providers
  • Solid team player and team building skills
  • Strategic thinking with proven ability to communicate a vision and drive results
  • Solid negotiation and conflict management skills  
  • Creative problem-solving skills 
  • Excellent interpersonal communication skills and ability to influence in executive settings
  • Superior presentation skills for both clinical and non-clinical audiences
  • Proven ability to develop relationships with network and community physicians and other providers

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with UnitedHealthcare. Work with a Fortune 5 organization that’s serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.

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

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.

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