Uhc Careers – Chief Operating Officer

Job Description:

The Chief Operating Officer is responsible for management of all business operations and ensuring contractual compliance for the Medicaid and Dual Special Needs Plan (DSNP/Medicare) lines of business. This role provides subject matter expertise in project management, project scope definition, risk identification, project methodology, resource allocation, stakeholder engagement and strategic direction.

The COO is also responsible for the design, coordination, and completion of operational improvement projects across various functional areas within UnitedHealthcare. The COO will review the departments performance and effect change as needed to improve service, simplify the workflow, and assure compliance with regulatory requirements. They will effectively lead a team that is focused on making a difference for our members and our state partners.

Job Responsibilities:

• Develops collaborative relationships with and confirms business partners can execute day-to-day responsibility for operations (member services center, enrollment, technology, DSNP Product etc.)
• Deliver value to members by optimizing the member experience and maximizing member growth and retention
• Meets with state customers and regulators to collaborate on program improvements and customer program goals
• Partners with Compliance Officer to manage process for timely and accurate regulatory reporting (non-financial) to Rhode Island Executive Office of Health and Human Services (EOHHS)
• Owns business analysis and successful implementation of new contractual requirements.
• Supports internal and external audits and accreditation activities
• Ensures all operational activities conform to contract compliance for Medicaid and DSNP lines of business.
• Understands state and federal legal and contractual regulations and requirements; translate requirements into operational metrics and protocols
• Lead and influence Health Plan employees by fostering teamwork and collaboration, and driving employee engagement and leveraging diversity and inclusion
• Manages health plan staff/matrix staff responsible for delegated Subcontractor oversight, and onboarding and monitoring of vendors/subcontractors
• Identifies and implements performance opportunities including those to improve Member experience and Provider experience, efficiency, and accuracy. Owns end-to-end process improvement: definition of need, project plans, status updates, reporting and achieving results
• Supports the development and execution of strategies to maximize growth, member retention, innovation, and member/provider experience for all products (Medicaid and DSNP)
• Informs and advises management regarding State’s current trends, and problems and activities to facilitate both short- and long-range strategic plans to improve operational performance and enhance growth
• Identifies and remediates performance issues and assist department leads in resolving complex technical, operational, and organizational problems
• Drive high-quality execution and operational excellence by communicating clear directions and expectations
• Primary lead for monthly state oversight meetings; Develops and implements strategies to maximize performance on annual state partner survey
• Provides strategic leadership of provider network strategy to drive growth and performance, including oversight of Medicaid Accountable Entity (ACO) program

Job Requirements:

• Advanced analytical and problem-solving skills
• Excellent communication skills
• In depth understanding of challenges that face health plans and health care in general
• Full COVID-19 vaccination is an essential job function of this role.
• Working knowledge of relevant federal and state regulations and requirements pertaining to Medicaid and Medicare
• Exceptional leadership skills and operational management expertise
• Technical and financial understanding of health plan operations
• Knowledge of and experience related to publicly funded government health care programs (e.g., Medicaid, Medicare, or State health care programs for the uninsured)

Qualification & Experience:

• 5+ years of leadership experience
• Master’s degree
• 5+ years of experience in matrix environment
• 5-7+ years of related managed care experience
• Bachelor’s degree

Job Details:

Company: United HealthCare

Vacancy Type: Full Time

Job Location: Greensboro, NC, US

Application Deadline: N/A

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