Florida Executive Director - Community & State - Sunrise, FL

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)

Primary Responsibilities:

• Accountable to plan, direct, operationalize, manage and evaluate assigned health plan activities for the LTSS product; responsible for the Product P&L and leadership of 250+ employee team and carries out supervisory responsibilities in accordance with established policies and applicable laws; development and ownership of all LTSS clinical programs


• Assists in defining contract terms and rate adjustments with providers


• Ensures corporate departments provide excellent service to state customers, i.e. members and providers; assists in detecting service problems and coordinating solutions with the health plan, segments and corporate office


• Ensures business operations are in compliance with applicable state and Federal laws and with contractual obligations to state Medicaid, providers and others; understands thoroughly and administers the contracts for all lines of business within the region


• Participates in formulating and administering company policies and developing long-range goals and objectives as they relate to the state health plan


• Represents the state health plan professionally to customers such as state Medicaid and other important business relationships; establishes and maintains excellent business reputation


• Monitors state activities, costs, operations, etc. to determine progress toward state objectives


• Develop and maintain strong relationships within the community including providers, business partners and community alliances, etc.


• Assists in ensuring regulatory compliance confers with the United Healthcare Community Plan of FL president to review achievements and discuss required changes in goals or objectives resulting from current state status and condition

Required Qualifications:

• Degree in business administration, health care administration


• 7+ years of experience in a Medicare/Medicaid industry, at-risk managed care environment


• 5+ years of experience administering managed long-term care programs


• Large operations leadership experience


• Experience working with LTSS and Medicare, provider network contracting/relations, distribution and community relations


• Experience in strategic planning and development


• Management, including supervisory experience


• Proven leadership skills in both internal and external environments, including creating and delivering persuasive presentations on complex topics to management and public groups


• Ability to execute to short and long term growth and profitability targets diversity creates a healthier atmosphere


• Demonstrated successful leadership skills in program execution and people

Preferred Qualifications:

• MBA


• Previous P&L experience in a health care or managed care environment

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)

Diversity creates a healthier atmosphere: 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.

Job Keywords: managed care, Medicare, Medicaid, Long-term care, P&L