Part-Time Dental Director-DDS-UHC Comm. Plan of MO

You're looking for something bigger for your career. How about inventing the future of healthcare? UnitedHealthcare is offering an innovative new standard for care management. We're pushing ourselves and each other to find smarter solutions. The result is a culture of performance that's driving the healthcare industry forward. As a Medical Director you will use your talents to take our already-exceptional service and innovation to the next level. You will lead a team of world-class professionals who are removing barriers to better health with every new idea. Ready for a new path? Join us and start doing your life's best work.(sm)
 
The C&S Plan Dental Director has accountability for ensuring that  local health plan , United Clinical Services and UHC initiatives focusing on clinical excellence, quality ratings improvement, appropriate office and outpatient utilization, health care affordability, health system transformation including provider network issues, mandated provisions and compliance, growth and focused improvement are implemented and successfully managed to achieve goals. 
 
This position reports to the local C&S plan Chief Medical Officer and has dotted line relationships to the C&S Chief Medical Officer and UCS market-assigned Regional Chief Medical Officer. The Dental Director also works collaboratively with any additional local health plan product Medical Directors to support unique populations, requirements and goals. The C&S Plan Dental Director’s primary responsibilities are directed towards C&S plan activities as defined by the C&S plan CEO/CMO and also collaborates with United Clinical Services (UCS) staff including the regional Chief Medical Officer, and other market and regional matrix partners to implement programs to support and meet market C&S, UHC/UCS and line of business goals.
 
Primary Responsibilities:

Quality and Affordability - The Plan Dental Director has primary responsibility and accountability for Total Dental PMPM performance and targets for the local C&S plan. This will require a close working relationship with vendors/partners, UCS clinical operations teams as well as with the C&S and UCS national affordability team. Activities will include collecting, analyzing and reviewing utilization and quality reporting to assess for over and underutilization patterns and gaps in care. In coordination with the CMO, Quality Management, Network and/or UCS, contributing to--and implementing—initiatives and data sharing with dentists and dental  groups on quality and efficiency improvement opportunities, and implementing local Health Care Affordability Initiatives.  The Dental director will serve as clinical lead for dental affordability initiatives at the local market and establishing a process for sharing data with physicians and completing peer to peer communications as required. Additionally the Plan Dental Director, working with dental staff,  has primary responsibility to oversee new clinical model operations where appropriate, including Person-Centered Care Models (PCCM), (Accountable Care Community/ACC) relationships, and new Models of Care programs such as those defined by AHCCCS, DDD and/or the Center for Medicare and Medicaid Services (CMS). S/he will support UCS and UHN initiatives and Quality Affordability Programs as required in order to achieve the appropriate utilization and affordability goals of the C&S Health Plan and United Clinical Services/UHC. The Plan Dental Director has oversight responsibility of the C&S market peer review process as defined by State regulator as well as participating in the Peer Review committee as needed.
Clinical Excellence - The C&S plan Dental Director works directly with the Quality Management Department and helps oversee the HEDIS data results and drive any required Health Plan accreditation activities as well as quality rating initiatives for the local CMS plan. The plan Dental Director has shared accountability for HEDIS performance for the Local C&S plan for Dental measures. The Dental director may also act in a similar capacity for Non C&S HEDIS, STARs as directed by UCS regional CMO (provider and member survey components). S/he acts as an improvement catalyst for all quality-related and will help in communications to providers on new focus and measure/process changes.  Supports all Clinical Quality initiatives and peer review processes including Quality of Care and Quality of Service issues and PA oversight.
Relationship Equity and State Compliance - The Plan Dental Director maintains a strong working knowledge of all government mandates and provisions for the local C&S market, as well as working across the enterprise to implement and maintain compliant clinical programs, procedures and work plans.  S/he also is committed to being effectively engaged with our external constituents such as consumers/members, physicians, dentists, medical and specialty societies, federal/state regulators, and market-based collaborative.  The plan Dental Director will be the outward face to State regulators based upon Contract, and direction of Plan President and C&S CMO.  All public speaking and media documents must be approved by UHC’s Chief Medical Officer and Community and State’s Chief Medical Officer.
Innovation - The Plan Dental Director leads the clinical interface with care providers and UHC network management colleagues in efforts to transform the health system. Primary local responsibility is to support dental linkages to PCCM/Accountable Care Community (ACC) growth through identification of appropriate practices; initial contact and into implementation where applicable. Knowledge of Value Based contracting variants for C&S will be required and will include but not limited to, UHC’s Accountable Care Platform, clinical practice transformation, patient-centered medical homes, accountable care organizations, creative care management programs, high-performance networks and network optimization, and consumer engagement.
Growth - This Dental director delivers the clinical value proposition focused on quality, affordability and service, in support of growth activities of the C&S Health Plan. The Plan Dental Director actively promotes positive relations with State/local regulatory authorities and Medical Societies and records such in online Physician Engagement (PEI) tool.
Focused Improvement - The Plan Dental director is responsible for identifying opportunities through participation, or review of, regional and/or local Market reviews S/he provides local feedback and takes a leadership role in Quality Affordability Programs initiatives.
Grievance and Appeals - the Plan Dental Director maintains an active liaison with UCS G&A, reviews dental and medical/dental cases, and is responsible for representing the Local C&S plan at State-level Fair Hearings as requested.

Required Qualifications:

Licensed dentist
Missouri resident
5+ years clinical practice experience
Knowledge of managed care industry and the Medicaid line of business
Familiarity with current medical/dental issues and practices
Strong leadership skills, as demonstrated by continuously improved results, team building, and effectiveness in a highly matrixed organization
Excellent interpersonal communication skills
Presentation skills for both clinical and non-clinical audiences
Proven ability to develop relationships with network and community physicians and other providers
Solid data analysis and interpretation skills; ability to focus on key metrics
Strong team player and team building skills
Strategic thinking with proven ability to communicate a vision and drive results
Solid negotiation and conflict management skills 
Creative problem solving skills
Proficiency with Microsoft Office applications
Preferred Qualifications:

Ability to build a team that values organizational success over personal success; provide ongoing coaching and feedback to ensure peak performance; identify and invest in high-potentials; actively manage under-performance
Focus staff on the company's mission; inspire superior performance; ensure understanding of strategic context; set clear performance goals; focus energy on serving the customer; provide ongoing communication to the team; discontinue non-critical efforts
Drive disciplined fact-based decisions
Execute with discipline and urgency
Drive exceptional performance; 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
Drive change and innovation though continually seeking and implementing innovative solutions; create a culture that thrives on continuous change; inspire people to stretch beyond their comfort zone; take well-reasoned risk; challenge "the way it has always been done"; change direction as required
Model and demand integrity and compliance
Proven ability to execute and drive improvements against stated goals
Ability to develop relationships with network and community physicians and other providers
Visibility and involvement in medical community
Ability to successfully function in a matrix organization
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: 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.
 
 
Job Keywords: Healthcare, dental, part time, director, Maryland Heights, MO, Missouri