C&S Plan of Indiana - Chief Medical Officer

At United Healthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start
Caring. Connecting. Growing together

The Community & State Plan of Indiana Chief Medical Officer (CMO) will use their proven track record to become the end-to-end owner of the clinical, quality and value-based provider leadership and financial outcomes. The position has accountability for all health plan product clinical product offerings, clinical market strategies, collaboration and oversight of our Shared Services clinical team, clinical data analysis to improve clinical and cost outcomes, new clinical program implementations, monitoring and valuing clinical outcomes and operational performance, driving affordability pipeline and performance, overseeing development and implementation of initiatives to meet quality standards, ensuring compliance with state Medicaid compliance standards-where applicable, and value based initiatives through clinical and vendor organizations.

The Indiana CMO is also responsible for the clinical relationships with our state client and key clinical leaders across Indiana.

If you are located in Indiana, you will have the flexibility to work remotely
* as you take on some tough challenges.

• Clinical Quality and Operational Performance
  - Oversight of clinical processes and policy decisions with a focus on implementing plans of care that meet accepted guidelines and protocols to ensure that optimal and appropriate medical/ clinical and Long-Term Support Services are provided in a cost-effective manner
• Strategic Clinical Leadership and Innovation
  - Development, implementation, and oversight of the population health strategy
• Serves as chairman of the Health Plan's Quality Improvement Committee (QIC)
• Financial oversight
  - Drive improved affordability related to medical and pharmacy spend for lower TCOC, greater capture of state level quality-based incentive dollars, and improved provider diagnosis, documentation and capture of member chronic conditions
• Ensure services are delivered to members at the highest quality standards. Oversee and ensure development and implementation of initiatives to meet or exceed HEDIS quality standards, and accreditation standards through working with and holding Quality Shared Services accountable
• Develop solid collaborative partnerships across a highly complex and matrixed organization including key partnerships with the local Market leadership team, functional VPs, Market CMOs, health plan CEOs and Executive Directors across all lines of business (Commercial, Medicare, Medicaid)
• Continuously improve HEDIS, and CAHPS scores for members and providers
• Provide guidance and direction to physicians and nurses regarding all aspects of medical care and multi- level transitions of care including the referral process as well as any quality-of-care concern and related plans of correction
• Review inpatient cases where applicable for successful bed-day management that meets established company goals
• Analyze utilization data to identify trends and opportunities for process improvement related to medical treatment (inpatient and outpatient)
• Serve as clinical subject matter expert for needs assessment, design, implementation, and evaluation of clinical programs to support continued growth and affordability of the Health Plan
• State and Community Advocacy
  - Cultivate and sustain solid relationships across stakeholders to influence program design, develop support for program efforts, secure approvals and foster collaborative partnerships
• Participate in senior medical management strategy development and implementation to ensure that appropriate care and services provided to members meet best practice standards as well as regulatory compliance requirements and Internal Quality Assurance Program
• Educate physicians and nurses in effective management of Health Plan benefits and medical services that meet…