UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.
Evercare, a UnitedHealth Group company, is the nation's largest provider of essential, innovative products and programs specifically designed to serve aging and chronically ill Medicare and Medicaid patients. We offer our members a simple way of achieving better health. Evercare offers a variety of services to help people in all phases of long-term care remain self-sufficient and independent for as long as possible. The company is part of Ovations, a family of UnitedHealth Group businesses dedicated to improving the health and well-being of Americans ages 50 and older.
Evercare is one of two health plans serving close to 40,000 Medicaid recipients in the New Mexico Coordination of Long Term Care Services (CoLTS) program. Evercare is a premier clinical care management organization, and collaborates with federal and state leaders to create new programs like CoLTS. Evercare also provides Medicare Advantage Special Needs Plans for New Mexicans living in a nursing home or who are dually eligible for Medicare and Medicaid.
The Chief Operating Officer for Evercare of New Mexico will be responsible for formulating and implementing business strategies and operational plans to ensure the successful stabilization and ongoing management of the CoLTS Medicaid program and coordination with the Evercare MA Dual/Institutional SNP plan(s). The Vice President will work closely with the Executive Director to address strategic, clinical, operational, and financial issues revolving around the business and chart the direction for the organization's future.
Primary objectives of the COO
- Position Evercare New Mexico organization for success - both CoLTS and MA SNPs
- Design and implement appropriate operational structure and processes
- Lead & assist in building a strong and cohesive team
- Lead & assist in driving vendor performance and strong working relationships
Responsibilities:
- Partner with Executive Director on the development of overall program strategy and business objectives.
- Lead Medicaid Non-Clinical Leadership team, with primary responsibility for translating business/program vision and strategy into operational tactics and building the necessary organizational support and infrastructure.
- Establish post implementation strategy and goals to mitigate program risks
- Facilitate leadership team in the establishment of organizational goals and priorities to align and focus health plan organization.
- Oversee health plan Network, Sales and Operations departments including intra-segment and vendor relationships.
- Establish business metrics required to meet State of New Mexico contractual requirements and achieve financial viability targets related to business operations.
- Run the operating business in a manner that systematically improves operational execution and delivers on the CoLTS value proposition to the State of New Mexico, our provider network, and the members we serve.
- Establish and oversee controls to ensure correct operational processes are in place.
- Initiate and oversee operational plans and initiatives to create cross functional capabilities required across key functional areas including network, business operations and sales.
- Develop and coach business operations leadership team.
- Ensure contractual agreements and obligations are met. Provide senior-level guidance and support in the development and management of customer, vendor and share services relationships.
- Complete ongoing assessment of operating business risks/opportunities and identify strategies to mitigate/capitalize as appropriate.
- Partner with corporate implementation team and other key stakeholders in ensuring plan performance and operational capabilities are operating correctly
- Escalate key issues and work to resolve to maintain contract compliance and responsiveness.
- Partner with Executive Director and New Mexico Clinical leadership to manage Medicaid program P/L and engage finance team to manage financials and anticipate key risks/opportunities
- Navigate corporate organization to identify best practice and leverage existing capabilities within the broader Unitedhealth Group organization to support needs of the program.
- Develops, translates and executes key provider relations strategies or functional/operational objectives for Evercare products including but not limited to provider servicing standards and contract pricing, negotiations and viability of contracts.
- Provides leadership to and is responsible for Medicare SNP product sales performance as well as CoLTS Medicaid market share growth through strategic account management, product expansion and by building/enhancing Evercare business operations reputation.
- A bachelor's degree is required; a master's degree in business, operations, and health services is strongly preferred.
- 8+ years progressive management experience of complex operational or health services functions in a matrixed environment.
- Proven ability to develop and coach other leaders.
- Broad functional capabilities including product management, strategic planning, business operations, network, sales and technology management experience.
- Experience in start up operations and ability to manage rapidly changing business requirements.
- Organizational design and development background with ability to anticipate changing business requirements and translate into key priorities or changes within organizational structure.
- Experience with state customers and influencing/partnering to improve overall program design requirements.
- Ability to navigate and influence within corporate organization to bring focus and accountability to resolving critical operational issues.
- Revenue management and understanding of state payment methodologies within managed care products.
- Business operations leadership experience within government programs
- Proven track record of optimizing organizations and creating significant operational and productivity improvements.
- Strong analytical background and ability to establish aggressive goals and deliver results.
- Ability to translate business goals into metrics and drive team results.
- Business disciplines to facilitate quick and data-based decisions and ensure accountability for execution. Evaluates outcomes based on qualitative and quantitative measures and adjusts accordingly.
- Proven track record in effectively leading and managing project management teams to produce on-time, high-quality deliverables with a high level of customer satisfaction.
- Maximizes customer linkages and leverages resources, collaboration and efficiency.
- Willingness to take calculated risk.
- Leads inspirationally and nurtures commitment to a common vision and shared values.
- Anticipates and pushes change through the organization, equipping staff to adapt quickly.
- Facilitates holistic thinking/problem solving and integrates efforts/result.
- Aligns people and resources with strategic priorities.
- Communicates in a manner that fosters understanding, commitment and results.
- Ability to adapt and manage using multiple leadership styles and communication to ensure cultural fit within local internal and external environment.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment
Additional Information:
|
