1+ months

Health Services Director - Seattle, WA - 893504

Seattle, WA 98104
  • Job Code
    893504
PURPOSE OF JOB:
The Community & State (C&S) Regional Health Services Director provides national oversight of core and complex care clinical program adherence and outcomes for one of the 3 designated regions within C&S. Complex care populations include but are not limited to the Dual Special Needs Plan (DSNP), Managed Long-Term Supports and Services (MLTSS), Private Duty Nursing (PDN), and maternity members. This leader will work in close partnership with the Complex Care Product, Clinical Capabilities, Local Affordability and Clinical Strategy teams in addition to local health plan leadership.

DUTIES INCLUDE:
*"HSD onboarding, training and support
*"Interim HSD support for greenfield markets or vacated positions
*"SME for RFP Development and implementation for complex care markets
*"Provide thought leadership through ongoing & annual evaluation of the care management programs to ensure efficacy. Partner with the health plan leaders to adapt clinical interventions as appropriate to better meet the needs of the population.
*"Partner with the compliance leads and adherence teams on all compliance-related topics, and ensure, from a clinical operational perspective, there is compliance with all clinical care management and documentation requirements, policies, and procedures.
*"Support with clinical internal and external audits and accreditation activities.
*"In partnership with the Quality team, develop a work plan geared towards continuous quality improvement inclusive of clinical care management operations and performance
*"Assisting Sr. director with establishing MBOs for HSDs that align with QD and CMO MBOs
*"Sharing, supporting and implementing remediation plans to ensure LTSS, DSNP MOC and NCQA Care Management adherence
*"Drive consistency amongst C&S clinical operations models and performance
*"Collaborate with national affordability team to strategize and remediate complex care affordability projects within designated markets
*"Serve as the link between health plan requirements and national support functions, including requests for program changes, implementation, training, etc., balancing local customization with national scale and efficiency.
*"Understand state and federal legal and contractual complex care case management regulations and requirements; translate requirements into operational metrics and protocols
*"Accountable for ensuring clinical remediation plans are developed and successfully implemented for corrective action plans
*"Drive collaboration between health plans and shared service partners to use audit and reporting metrics to ensure performance against contractual and regulatory requirements

QUALIFICATIONS:

*"UHC affordability experience preferred
*"Undergraduate degree or equivalent experience required
*"healthcare experience including Managed Care experience, healthcare administration and or healthcare consulting experience
*"Experience within healthcare operations, clinical services, network, products and benefits
*"Customer-focused; proven ability to handle complex situations, resolve conflicts and issues effectively. Sensitive to how people and the organization function
*"Demonstrated ability to translate strategic objectives into action plans and lead / motivate teams to execute plans effectively; flexibility to adapt and change direction as needed

ROLES OF LEADERSHIP CRITICAL TO SUCCESS:
*"Vision - shaping and orchestrating a compelling, forward-looking vision that guides each business (e.g. their region) and contributes to the enterprise (e.g. C&S)
*"Plan - creating and executing an operational annual plan to accomplish the strategy (e.g. clear, concise work plans for the ad hoc initiatives they are supporting)
*"Structuring and Staffing -- attracting and selecting staff and structuring roles and responsibilities; deploying aligned staff whose capabilities enable the organization to achieve its goals (e.g. being able to clearly articulate their role to the HSDs/clinical leadership as well as supporting those individuals to effectively and efficiently do their jobs)
*"Progress & Results - monitoring and measuring progress against plan; providing real time supportive and corrective feedback and assistance
*"Represent & Respond to Stakeholders - preparing and delivering presentations to and fostering relationships with critical stakeholders; recognizing and responding to the diverse needs of key inside and outside stakeholders (e.g. C&S clinical leadership, RCEOs)
*"Conflict Management - refereeing the inevitable individual, team and business unit conflicts; offering assistance and direction moving to productive resolution

PRACTICE DESCRIPTIONS & OBSERVABLE BEHAVIORS CRITICAL TO SUCCESS:
Leading Myself
1."Leading Change and Transitions
2."Resilience & Resourcefulness
3."Demonstrating Presence
4."Growth Mindset

Leading People
1."Motivating & Influencing
2."Conflict Management & Agility
3."Reading & Understanding Individuals
4."Task & Project Management

Managing My Thinking
1."Problem Analysis
2."Critical Thinking
3."Systems Thinking

Applying Knowledge & Experience
1."Technical & Functional Skills
2."Vision & Strategy Formulation
3."Enterprise Insight

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.

Categories

Posted: 2020-11-25 Expires: 2021-02-21

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Health Services Director - Seattle, WA - 893504

UnitedHealth Group
Seattle, WA 98104

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