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Hours Full-time, Part-time
Location Miramar, FL
Miramar, Florida

About this job


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)


We are looking for a talented Chief Operating Officer that reports directly to the CEO of the health plan. An exciting and challenging role with responsibilities to develop and set strategic direction in collaboration with the Executive team, provide tactical execution, leverage and integrate processes within a highly matrix structure.


 


Primary Responsibilities:



  • Involvement with all aspects of Multi-Product Community & State Market including Medicaid Managed Care, Long Term Care, CHIP, and Dual Eligible Special Needs Plans [DSNP]

  • Network Relationships, Value Based Contracting Initiatives Enrollment, Operations, member and provider support

  • Along with the Senior Management Team set strategies, goals, programs, best practices and compliance improvement projects for each product line improving operational execution and delivering on our value proposition to customers and members

  • Establish member growth programs and manage campaigns to achieve top line revenue targets

  • In collaboration with the Chief Medical Officer and the Executive Directors executes and achieves the goals of the Clinical Care Model.

  • Maximization activities such as risk score improvements

  • Develop and oversee marketing and member outreach activities

  • Achieve Operational Excellence with our internal and outsourced processes

  • Ensure regulator and vendor contractual compliance requirements including correspondence management and regulatory reporting

  • Achieve all regulator established and internal operating metrics

  • Achieve member and provider satisfaction goals and improvement programs

  • Oversee the development and implementation of all health plan policies and procedures

  • Manage network strategy, adequacy, access and service

  • Improve internal and inter-segment operational efficiencies

  • Assess operating business risks/opportunities and identify strategies to mitigate/capitalize as appropriate.

  • Direct due diligence and integration of new business.

  • Achieve targeted employee engagement and satisfaction scores for the health plan

  • Achieve financial profitability targets for the health plan

Requirements


Required Qualifications: 


  • Bachelor's degree in Health Care Administration, Business, or Management

  • 5+ years of related managed care experience 

  • 5+ years of people management experience 

  • Knowledge of and experience related to publicly funded government health care programs (e.g., Medicaid, Medicare or State health care programs for the uninsured)

  • Technical and financial understanding of health care operations

  • Ability to advise IT resources related to enterprise platform initiatives; provides direction on platform migration

  • Experience in matrix environment

  • Exceptional leadership skills and operational management expertise

  • Excellent communication skills

  • Strong analytical and problem solving skills

  • Working knowledge of relevant federal and state regulations and requirements

  • In depth understanding of challenges that face health plans and health care in general

  • Ability to stay apprised of ongoing changes that impact health plan operations



Preferred Qualifications: 



  • Master's degree

  • NCQA experience

 


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, Medicaid, Miramar, FL, Florida