1+ months

Chief Operating Officer - Community and State - Mississippi - 921967

Ridgeland, MS 39157
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  • Job Code
    921967

Chief Operating Officer Community and State - Mississippi

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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 doingyour life's best work.

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The chief operating officer is responsible for management and administration of multiple functions and general business operations, health services and the medical management team. This role provides subject matter expertise in project management, project scope definition, risk identification, project methodology, resource allocation and other areas of expertise.

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"The COO is also responsible for the design, coordination and completion of operational improvement projects across various functional areas within UnitedHealthcare. The COO will review the departments performance and effect change as needed to improve service, simplify the workflow, and assure compliance with regulatory requirements. They will effectively lead a team that is focused on making a difference for our members and our state partners.

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The COO is also responsible for management and administration of multiple functions and general business operations, provider services and member services. This position manages daily operations of multiple levels of staff and multiple functions/departments across UnitedHealthcare.

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Primary Responsibilities:

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  • Sets business direction, develops, and implements and oversees operational models to meet the unique needs and business requirements for UnitedHealthcare
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  • Confirms operations and service models are optimized
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  • Develops collaborative relationships with and confirms business partners can execute day-to-day responsibility for operations (member services center, enrollment, technology, etc.)
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  • Informs and advises management regarding States current trends, and problems and activities to facilitate both short- and long-range strategic plans to improve operational performance and enhance growth
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  • Owns end-to-end process improvement: definition of need, project plans, status updates, reporting and achieving results
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  • Identifies and resolves technical, and operational and organizational problems inside and outside health plan
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  • Confirms all operational activities conform to contract compliance for all programs
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  • Understands and manages the State requirements and relationship related to operations
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  • Provides governance on network strategy and development
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  • Monitors required reporting and provides direction on findings
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  • Directs others to resolve business problems that affect multiple functions or disciplines
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  • Provides leadership to and is accountable for the performance and direction through multiple layers of management and senior level professional staff
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  • Support with clinical internal and external audits and accreditation activities.
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  • In partnership with the Quality team, develop a work plan geared towards continuous quality improvement inclusive of clinical care management operations and performance
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  • Collaborate with national affordability team to strategize and remediate complex care affordability projects within designated markets
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  • Serve as the link between health plan requirements and national support functions, including requests for program changes, implementation, training, etc., balancing local customization with national scale and efficiency.
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  • Understand state and federal legal and contractual complex care case management regulations and requirements; translate requirements into operational metrics and protocols
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  • Accountable for ensuring clinical remediation plans are developed and successfully implemented for corrective action plans
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  • Drive collaboration between health plans and shared service partners to use audit and reporting metrics to ensure performance against contractual and regulatory requirements
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Leadership Expectations: Demonstrate Leadership and Cultural Values

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  • Deliver value to members by optimizing the member experience and maximizing member growth and retention
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  • Lead and influence Health Plan employees by fostering teamwork and collaboration, and driving employee engagement and leveraging diversity and inclusion
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  • Lead change and innovation by demonstrating emotional resilience, managing change by proactively communicating the case for change and promoting a culture that thrives on change
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  • Drive sound and disciplined decisions that drive action while effectively using financial knowledge and data to manage the business
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  • Drive high-quality execution and operational excellence by communicating clear directions and expectations
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  • Experience within healthcare operations, clinical services, network, and products and benefits
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  • Customer-focused; proven ability to handle complex situations, resolve conflicts and issues effectively. Sensitive to how people and the organization function
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  • Demonstrated ability to translate strategic objectives into action plans and lead / motivate teams to execute plans effectively; flexibility to adapt and change direction as needed
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Required Qualifications:

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  • Bachelors degree
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  • Master's degree preferred
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  • 5+ years of related managed care experience
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  • 5+ years of leadership experience
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  • Knowledge of and experience related to publicly funded government health care programs (e.g., Medicaid, Medicare or State health care programs for the uninsured)
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  • Technical and financial understanding of health care operations
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  • Ability to advise IT resources related to enterprise platform initiatives; provides direction on platform migration
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  • Experience in matrix environment
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  • Exceptional leadership skills and operational management expertise
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  • Excellent communication skills
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  • Strong analytical and problem-solving skills
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  • Working knowledge of relevant federal and state regulations and requirements
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  • In depth understanding of challenges that face health plans and health care in general
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  • Ability to stay apprised of ongoing changes that impact health plan operations
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Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.SM

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"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.

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

Posted: 2021-04-21 Expires: 2021-06-19

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 Operating Officer - Community and State - Mississippi - 921967

UnitedHealth Group
Ridgeland, MS 39157

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