Tennessee Executive Director – Community & State - Brentwood, TN - Full-time / Part-time

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)

Tennessee's LTSS program, known as CHOICES, is considered a national model and UnitedHealthcare is fortunate to be one of 3 payors engaged with the TennCare Bureau to assure cost effective care and services to the CHOICES program members. We strive to assure that CHOICES members maintain quality lives in their communities through comprehensive and creative treatment planning.

The successful candidate will possess compassion for the CHOICES membership and exhibit strong leadership and vision to assist the TennCare Bureau and UnitedHealthcare in living the mission of the provision of cost effective quality health care services for CHOICES members.

Bring your experience in leading long-term care programs, and your innovative ideas, to provide the highest level of care each and every day to these fragile members.

You are accountable to plan, direct, operationalize, manage and evaluate assigned health plan activities for the LTSS product (CHOICES), optimizing the use of the full spectrum of care options to bring these members, and their families, an experience where the emphasis is on care.  

Primary Responsibilities: 

• 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 (CHOICES) 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 TN president to review achievements and discuss required changes in goals or objectives resulting from current state status and condition

• Degree in business administration, health care administration


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


• Minimum of 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
  


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


• 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
  


• Demonstrated successful leadership skills in program execution and people management

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, national origin, protected veteran status, or disability status.

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

Job Keywords:  Tennessee Executive Director, Business Administration, Health Care Administration, Medicare, Medicaid, Brentwood, TN, Tennessee