Regional Director Medical Clinical Ops- Northeast Region - Full-time / Part-time

The Regional Director of Medical/Clinical Operations-NE Region will have regional accountability for oversight and performance of Medicaid service delivery operations. They will provide strong leadership in operations driving performance, managing change, building teams, and influencing in a matrix organization. The individual will drive continual improvement in operational performance, quality measures and affordability. They will lead an interdisciplinary team and drive employee engagement and collaborate with other functional leaders to evolve program design and delivery. Teams will be comprised of primarily field based staff with some telephonic operations. 

Primary Responsibilities:

• Develops and executes strategies that span  multiple sites including medical management, financial accountability, customer and provider satisfaction, quality improvement


• Meet established customer affordability targets


• Supports leadership team and transformation to a market led model inclusive of field based staff, medical and behavioral integration, and the addition of Community Health Workers


• Directs others to resolve business problems that affect multiple functions or disciplines; direct


• Identify operational efficiencies to enhance operations, reduce operating costs, and  standardize best practices across the organization


• Ensures consistent service levels are maintained through managing staffing levels,   monitoring metrics, process improvement, and human resource management


• Lead in partnership with others improvement initiatives around quality and affordability across OptumHealth and Community and State


• Responsible for consistent application of standard policy procedure regulatory accreditation requirements for NCQA and State level requirements


• Systematically analyze problems, draw relevant conclusions and devise appropriate courses of action


• Identifies and resolves technical, operational, and organizational problems outside own team

Required Qualifications:

• 4 year degree


• 5 years leadership experience, preferably managing leaders


• 3 or more years health services operations experience


• Proven record in driving substantial quantifiable operational improvements


• Proficient in Microsoft Word, Excel, Power Point, Outlook


• Demonstrated ability to mentor, influence and negotiate


• Experienced managing a variety of complex issues while driving momentum of key projects


• Strong ability to lead, mentor and influence in environment of rapid change


• Ability to work in highly matrixed environment


• Strong interpersonal skills with successful relationship building skills


• Successful establishing trust and credibility at all levels of the organization


• Demonstrated, creative, resourceful problem-solver

Preferred Qualifications:

• Advanced degree


• CM experience 


• Medicaid/Medicare

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)