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Chief Clinical Officer - Atlanta, GA

Atlanta, GA 30303
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If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm)

Serve as Clinical Affordability Lead in the Premier Hub model in Atlanta. The role will be dedicated to one client.  This client is very complex and strategic for which the management of the trend is essential. This clinical position works in collaboration with the Lead Medical Director and Lead Operations Director to develop and implement action plans that achieve client outcome expectation. This will contribute to the retention of the client by ensuring programs provides exceptional clinical value and medical cost management. Consult with senior leadership and healthcare consultants to identify innovative strategies and tactics for operational excellence. Develop action plans to mitigate trend, monitor progress against plans, identify and prevent service quality issues. Develop and implement innovative clinical solutions to client-specific requirements. A clinical skill set is essential to identify and intervene appropriately to drive team and member engagement.

Primary Responsibilities:

  • Contribute to growth and profitability of the model by ensuring the program provides exceptional clinical value and medical cost management for each individual client through identification and valuation of solutions. Tasks include but are not limited to:
    • Develop and lead presentation of Medical Cost Action Plan  (MCAP) for the designated customer to effectively manage client's trend target. 
    • Partner with the Lead Medical Director, Strategic Client Executive, and Health Plan Consultant in developing the on-going customer strategy and specific recommendations
    • Provide strategic direction for Premier Hub client- determining products/services and benefit plan structure that will assist in mitigating a client's trend
    • Lead quarterly MCAP activities and drive the Small Group MCAP for customer specific savings or process improvement opportunities and report outcomes
    • Bring newly developed clinical solutions for cost containment to AMT for presentation and adoption by client using data and analytics
    • Coordinate necessary data elements and requirements with Health Analytics Consultant and underwriting to develop targets and manage trend
    • Provide a detailed review of data and analysis to target specific areas of client trend to focus on effective cost management
    • Organize and lead internal meetings to develop initiatives to address cost: cross organizational focus with product, affordability team, clinical operations and others
    • Provide valuation of the financials to determine net cost savings related to implementation of the targeted initiative (s) and determination if the client is on target to meet trend requirements
    • Analyze status of initiatives implemented and financial performance post implementation at the individual client level (continue to monitor and update the evaluations for proposed cost savings not implemented)
    • Lead effective business meetings/presentation with the sales and growth team, site leadership, staff and internal/external partners
  • Develop and lead integrated rounds between the clinical team, Optum Rx, Briova, Behavioral Health, Clinical Coverage Review, Inpatient Care Management and Advocates:
    • Management of blended census reporting and identification of cases for assignment to clinical team
    • Identification of additional opportunities for management or member outreach based on client specific programs and services
    • Coordinate and lead the daily round discussions for the assigned Premier Hub clients
    • Assist the team to drive resolution of any escalated member issues and identify opportunities for process improvement to mitigate future escalations
    • Track and value key interventions that lead to client savings
    • Engage additional organizational resources as required (e.g. Network, external business partners specific to the client)
  • Ensure that programs developed are continually monitored for effectiveness and updated/revised as needed to meet objectives:
    • Develop and maintain client specific action plans and tracking for the  Premier Hub Client
    • Develop client facing tools using applicable data and reports that demonstrate the outcomes of the trend management to the client (e.g. Executive Client Dashboards, Financial Outcome Measures)
    • Analyze data to determine effectiveness of the actions and implement improvement plans as required
    • Evaluate the need for customer specific predictive model (e.g. Hub Rules) and stratification of outreach efforts
    • Monitor and maintain clinical operations and associated functions (e.g. set-up including SBP, SAI, Dialer jobs, engagement targets and performances
    • Investigate and implement action plans to address any clinical operations deficiencies or defects
    • Own the ongoing operational metrics, clinical outcomes and financial commitments related to the Premier Hub model at a client level
    • Collaborate with customer analytics manager for clinical reporting for client presentations
    • Participate in internal RFP meetings to prepare and present documentation from the model and incorporate into the discussion or proposal 
    • Ensure Customer commitments are aligned with service delivery capabilities. Provide expertise to internal partners (clinical operations, product, etc.) to ensure programs are implemented based on client specific requirements and can be reported on effectively.
    • Conduct monthly meetings with impacted stakeholders to review program status and drive operational performance

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.


Jobs Rated Reports for Dietitian

Posted: 2020-03-25 Expires: 2020-04-25

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Chief Clinical Officer - Atlanta, GA

UnitedHealth Group
Atlanta, GA 30303

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43rd2018 - Dietitian
Overall Rating: 43/220
Median Salary: $59,410

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