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We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:

Medical and Clinical Operations



Approximate Salary:

Not Specified

Position Type:

Full Time

CMO - Clinical Redesign Team

UHG - Camden, New Jersey

Posted: 12/12/2018

The Clinical Redesign Team is a dedicated business unit focused on developing and deploying innovative direct care models for underserved populations.  The business unit is housed within Community & State, the Medicaid insurance arm of UnitedHealthcare.  The Clinical Redesign Team is deploying a range of direct care models targeting both complex and healthy populations including members with medical, mental health, addiction, and social complexity.  As the R&D, innovation team within Community & State, the business unit is charged with transforming the way care is delivered, to achieve better care at lower cost.
The Clinical Redesign Team is led by Dr. Jeffrey Brenner, MD and Kathleen Stillo, MBA who pioneered similar work in Camden, New Jersey through the Camden Coalition of Healthcare Providers and the Urban Health Institute at Cooper Health System.  Their work is driven by a deep belief in team-based care; continuous improvement; integration of services, protocolization and standardization of work; staff training and development; and patient/family/community centeredness.  The team is inspired by care models from around the world including the NUKA Health System run by the Southcentral Foundation in Anchorage, Alaska and the Aravind Eye Hospital in Madurai, India.
The Clinical Redesign Team uses modern business and clinical techniques to deliver care that is evidence-based, data-driven, and integrated.  Current services include housing and wrap around care for formerly homeless members, primary care in the home for frail home-bound members, short term stabilization and assessments, medication assisted treatment for substance use disorder, and primary care clinics. Some of the clinical techniques being used with patients include:  trauma-informed care, harm reduction, positive psychology, motivational interviewing, medication assisted treatment, and data-driven patient segmentation.  The team also draws upon a range of business best practices to ensure the services will scale and spread with strong fidelity and high quality service delivery. 
The Chief Medical Officer (CMO) will be a senior member of the leadership team helping to collaboratively drive strategy and growth of the business unit.  The CMO is responsible for the medical care we deliver. Specific responsibilities include clinical affairs such as provider recruitment, credentialing, training, ongoing oversight/mentoring, feedback, and compensation.  The CMO will collaboratively drive the development and deployment of our clinical model, clinical guidelines, and protocols; measurement systems and dashboards; and improvement cycles.  The CMO will become a national thought leader, sought after speaker, and source subject matter expert inside and outside the company.  The business unit seeks to influence national, state, and local policy and the CMO should be comfortable speaking with policy leaders and public officials. 
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. In total, the C&S business and operations employs over ten-thousand employees and serves over six-million members in 30 states and the District of Columbia. C&S is the largest health benefits company dedicated to the economically disadvantaged, medically underserved and those without employer-funded health care coverage.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
  • Serve as a member of the senior leadership team helping to drive strategy, business planning, and growth
  • Navigate and influence multiple cross-functional teams and internal vendors in a complex, matrix work environment
  • Support the ongoing development of a best in class national clinical governance model that complies with state-level corporate practice of medicine requirements
Clinical Model, Quality, and Healthcare Utilization
  • Develop and evolve clinical models and ensure clinical strategies use appropriate statistical and business measures to demonstrate operational success and expected long-term outcomes
  • Support matrix partners to ensure the business unit remains compliant with all clinical best-practices, regulatory requirements, and contract requirements
  • Oversee a national credential, peer review, quality assurance, and adverse event reporting process
  • Support achievement of breakthrough performance in MIPS, HEDIS and other quality indicators through development and execution of well-informed strategies
  • Collaborate with staff/leadership team to decrease unnecessary healthcare utilization and increase beneficial, cost-effective utilization using evidenced-based strategies


Medical Team Leadership

  • Recruit, interview, onboard, and mentor healthcare providers for our direct care services
  • Provide ongoing feedback to providers to ensure professional growth/development and outstanding clinical and business outcomes
  • Support the well-being of staff, managers, and leaders through self-care, appropriate boundary setting, and good internal HR and management practices
  • Through collaborative engagement, develop and continuously evolve provider compensation models which reward high quality, efficient, and patient-centered care
  • When needed, develop corrective action plans and manage providers out of the organization when performance does not meet expected standards


Thought Leadership and Training

  • Represent the business unit internally across United Healthcare to share clinical best practices and innovation learning to influence the evolving business and clinical models across UHG, Optum, and UHC
  • Represent the business unit externally as a thought leader and speaker to drive policy change and improve care of complex  and underserved populations at the national, state, and local level in public and non-public forums/meetings
  • Ensure staff, managers, and leaders receive ongoing training in clinical best practices using modern, adult learning theory
  • Ensure the use of external market trends and best practices related to clinical solutions from academic and non-academic sources into the business unit’s strategic planning, growth, and new model development
  • Support data analysis to articulate compelling value propositions to potential customers
  • Define and help to build the core competencies/capabilities that distinguish us in the marketplace (e.g., key differentiators)
  • Ensure program strategies address applicable market expectations and needs
  • Support growth through engagement with current and future customers

Required Qualifications:
  • Active and unrestricted medical license and significant experience caring for both medically and socially complex populations
  • Proven record of executive leadership/clinical management in a hospital system or large outpatient medical practice group
  • Ability to develop relationships with network and community physicians and other providers
  • Visibility and involvement in medical community
  • Expertise with current medical issues and practices and ability to drive continuous improvement in clinical quality
  • Expert at strategic conceptualization both at a local level and also within the framework of being a part of a national organization
  • Good negotiation, problem solving, planning and decision-making skills.  Accurately scopes out projects, sets objectives and goals, develops schedules and resource assignments, measures performance against goals, and evaluates results
  • Strong demonstrated ability to lead initiatives to a successful outcome.  Execute with discipline and urgency: Deliver value to the customer; closely monitor execution; drive operational excellence; get directly involved when needed; actively manage financial performance; balance speed with analysis; ensure accountability for results
  • Strong communicator; capable of effectively presenting ideas and selling concepts and tactics; excellent writer, proven ability to communicate effectively with executives; ability to quickly understand needs and act on those needs; ability to conceptualize and effectuate change management and "out-of-the-box" thinking
  • Proven cross-functional/matrix influence and well-developed relationship building skills, willing to take a leadership role driving initiatives, working across organizations and structuring approaches to new opportunities 
  • Drive change and innovation though continually seeking and implementing innovative solutions; create a culture that thrives on continuous change and ambiguity; inspire people to stretch beyond their comfort zone; take well-reasoned risk; challenge "the way it has always been done"; change direction as required
  • Demonstrated leadership and hands-on experience, strong leader and motivator with the ability to mentor talent within the organization; able to provide work direction; able to attract and retain top talent; identify and invest in high-potential talent; actively manage underperformance
  • Ability to travel
Preferred Qualifications:
  • Board Certified in Addiction Medicine or Geriatrics preferred
Careers at TeamMD:. Imagine. Even as health care evolves and advances into a future of innovative new practice models, there are some lessons from the past that can make a huge difference. At TeamMD, a part of UnitedHealthcare Community & State and the UnitedHealth Group family of businesses, we recognized the need for better care for individuals that are medically complex and have functional limitations. We created TeamMD to bring medical care to these individuals in their home to improve their access to care and enable better clinical outcomes. Our home-based model of care helps patients with the greatest needs, whether it is for short term stabilization and transition support to ongoing primary care. If you're looking for greater career impact and challenge, learn more. You'll discover how this can become your life's best work.(sm)
*All Telecommuters 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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