Community & State CMO – Kansas

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UnitedHealthcare is offering an opportunity for a physician to play a critical role on the Community Plan of Kansas’s executive leadership team to lead teams and clinical strategy to support the state’s most vulnerable populations in achieving healthier lives. The Kansas Health Plan serves over 150,000 Kansans receiving Medicaid and DSNP benefits.

Innovation in healthcare involves transforming the industry through integrated clinical models and value-based provider programs aimed at delivering quality care statewide in Kansas. This role provides continuous career growth opportunities supported by advanced tools, training, and collaboration with skilled colleagues and clinicians.

The CMO role is accountable for ensuring these Kansans achieve high quality clinical outcomes as evidenced by exceptional quality performance ratings, as well as high member and provider satisfaction scores. Furthermore, healthcare transformation is a priority focus of the CMO by continuously advancing a clinical model that engages underserved individuals in a population health model that is supported by integrated community care teams and providers in a value-based payment model.

This position reports to the Health Plan’s Chief Executive Officer (CEO) and has dotted line relationships to the Regional CMO and national clinical team. The CMO’s primary responsibilities are focused on local health plan clinical and business activities as defined by the Health Plan’s CEO. The CMO collaborates with other Medicaid markets and regional clinical shared service partners to implement KanCare’s managed Medicaid programs. The CMO also collaborates with Medicare clinical teams/CMOs, other markets and regional shared service partners including delegated provider partners to support DSNP programs. Activities support national, regional and local business goals tailored for the Kansas market.

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

Primary Responsibilities:

• Quality and Affordability – The Health Plan CMO has primary responsibility and accountability for quality medical outcomes and performance while championing healthcare affordability projects that ensure members receive the best possible care. This requires a close working relationship with the Kansas Medicaid’s clinical leadership team, operations teams, healthcare economics teams and actuaries. The CMO serves as the clinical leader for healthcare affordability initiatives in the local market. Additionally, the CMO is a primary stakeholder in clinical model operations including Person-Centered Care Models (PCCM), Kansas Delivery System Transformation and Value Based Program (VBP) relationships. This includes the design, collaboration, and implementation of new and or improved models of care such as those defined by the State contract, by Centers for Medicare and Medicaid Services (CMS) and the Centers for Medicare and Medicaid Innovation (CMMI). The CMO has oversight responsibility for the local market peer review process as defined by Kansas Medicaid, as well as participating in or leading the regional UHC Peer Review committee
• Clinical Strategy – The Kansas Health Plan CMO is the executive leader that sets the overall clinical strategy for the health plan aligned to business goals and the objective of improving outcomes, access and value for the members we serve.  This work includes:
  • Leading the creation and execution of comprehensive clinical plans that align with the health plan’s long-term objectives
  • Analyzing emerging clinical and utilization trends and innovations in healthcare to define a strategy and inform the execution of advancements in our clinical models and population health tactics
  • Spearheading population health and clinical interventions that improves clinical outcomes for our membership using clinical and financial data insights
  • Lead clinical excellence and act as an improvement catalyst for all quality related efforts including HEDIS, STARs, CAHPS, Health Plan accreditation activities and quality pay for performance goals in partnership with the Quality Director. This includes acting as the clinical liaison with providers for new focus and measure/process changes. Supports all Clinical Quality initiatives and peer review processes including Quality of Care and Quality of Service issues; participates or leads Physician Advisory Committees (PAC); Quality Management Committee (QMC) and other associated quality focused committees
• Relationship Equity and State Compliance – The Plan CMO is responsible for acting as the primary medical liaison to state and federal agencies – advocating for beneficial policies, providing expert guidance and shaping healthcare regulations to align with organizational goals
  • Lead initiatives to ensure rigorous adherence to federal and state regulations, Medicaid/Medicare standards, and contractual obligations, enhancing the quality of care delivered.  Includes solid working knowledge of all government mandates and provisions for KanCare
  • Act as the primary medical liaison to state and federal agencies – advocating for beneficial policies, providing expert guidance, and shaping healthcare regulations to better serve the KanCare program
  • Act as a consultative subject matter expert to government affairs, ensuring our organizational interests and interests of KanCare are effectively represented at all levels
  • Exhibit solid executive presence in leadership meetings and public forums, effectively representing our organization’s vision and values
  • The CMO provides clinical thought leadership with external entities, legislative oversight committee(s) and State’s Medicaid leadership (KDHE & KDADs)
• Integrated Care Delivery – The CMO will lead the strategy and guide the execution of integration of behavioral health, physical health, social care services to ensure holistic clinical model for KanCare members. This work includes the entire clinical model (end to end) within the market and the strategic partnerships with the care delivery system in the network to support the clinical model and quality objectives. The Plan CMO leads the clinical interface with providers and UHC network management colleagues in efforts to transform the health system
  • The CMO’s primary local responsibility is to drive provider performance through identification of appropriate practices; initial contact and target setting, and implementation of value-based care programs, as well as ongoing leadership during regular Joint Operating Committees (JOCs.)
  • Knowledge of value based contracting approaches for Medicaid is an essential secondary responsibility including clinical practice transformation strategies, patient-centered medical homes, accountable care organizations, novel care management programs, high-performance networks and network optimization, and consumer engagement tactics
  • Knowledge of and dedication to developing and improving an integrated service clinical model (medical, behavioral, and social risk) is required. The CMO must also create a culture of diversity and inclusion, with supporting programs targeted to reduce health disparity
• Growth – The CMO is responsible for defining and delivering the clinical value proposition focused on quality, affordability, and service, in support of growth activities of the Health Plan.  The CMO contributes to any RFP/re-procurement activities in the state and plays a critical role defining clinical strategy to support procurement needs. The CMO actively promotes positive relations with State/local regulatory authorities, medical societies, trade associations to ensure our value proposition is well understood. The CMO’s engagement, relationships and leadership, the State/local regulatory authorities will come to view the CMO as a trusted thought partner and key advisor on policies, procedures, and practices to improve care for Kansans
• Ensure Compliance – The CMO plays a critical role in compliance related activities such:
  • Liaison with Grievance & Appeals and is responsible for representing the health plan at state fair hearings at the state’s request
  • Representing the health plan as the clinical expert in all audit activities throughout the year
  • Testifying as needed at legislative oversight committees to represent the organization and sponsor the work we do on behalf of KanCare

Demonstrable Skills and Experience:

• Ability to build a team that values organizational and health plan success over personal success; provide ongoing coaching and feedback to ensure peak performance; identify and invest in high potential teams; actively manage underperformance
• Ability to focus staff on the company’s mission; inspire superior performance; ensure understanding of strategic context; set clear performance goals; focus energy on serving the customer; provide ongoing communication to the team; discontinue non-critical efforts
• Ability to drive disciplined fact-based decisions and craft strategy utilizing data insights
• Ability to execute with discipline and urgency; drive exceptional performance; deliver value to the customer; closely monitor execution; drive operational excellence; get directly involved when needed; actively manage financial performance; balance speed with analysis; ensure accountability for results. CMO is a leadership position within the health plan, a part of the “C” Suite, a skilled General Manager with a clinical expertise
• Ability to drive change and innovation though continually seeking and implementing innovative solutions; create a culture that thrives on continuous change; inspire people to stretch beyond their comfort zone; take well-reasoned risk; challenge “the way it has always been done”; change direction as required
• Ability to model and demand integrity and compliance
• Proven ability to execute and drive improvements against stated goals
• Ability to develop relationships with Kansas State government clinical leadership, network and community physicians and other providers
• Ability to be visible and be involved in the Kansas medical communit
• Ability to successfully function in a matrix organization exhibiting the culture of United Health Group

CMO Leadership Expectations:

• Deliver value to members by optimizing the member experience
• Maximize member growth and retention
• Lead and influence Health Plan employees by fostering teamwork and collaboration, driving employee engagement, and leveraging diversity and inclusion
• Develop and mentor others while also building awareness to your own strengths and development needs
• Influence and negotiate effectively to arrive at win-win solutions
• Communicate and present effectively, listen actively and attentively to others, and convey genuine interest
• Lead change and innovation by demonstrating emotional resilience, managing change by proactively communicating the case for change and promoting a culture that thrives on change
• Play an active role in implementing innovative solutions by challenging the status quo and encouraging others to do so
• Drive sound and disciplined decisions that drive action while effectively using financial knowledge and data to manage the business
• Drive high-quality execution and operational excellence by communicating clear directions and expectations
• Manage execution by delegating work to maximize productivity, exceed goals and improve performance

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Active and unrestricted Kansas medical license as a Doctor of Medicine (MD) 
• Board Certified in one or more of Internal Medicine, Family Medicine, Pediatrics, OB/GYN, Palliative Care or Psychiatry, Hospitalist
• 5+ years of clinical practice experience
• 2+ years of Quality Management experience
• Solid knowledge of managed care industry and the Medicaid line of business, including Utilization Management
• Proven solid leadership skills, as demonstrated by continuously improved results, team building, and effectiveness in a highly matrixed organization
• Proven excellent interpersonal communication skills
• Proven excellent project management skills
• Proven solid data analysis and interpretation skills; ability to focus on key metrics
• Proven solid team player and team building skills
• Proven strategic thinking with proven ability to communicate a vision and drive results
• Proven solid negotiation and conflict management skills
• Proven creative problem-solving skills
• Reside in Kansas with a preference for the greater Kansas City area
• Travel 25% throughout Kansas

Preferred Qualifications:

• Master’s degrees in public health, business administration or healthcare administration
• 2+ years of management experience
• Familiarity with current medical trends and practices
• Proficiency with Microsoft Office applications and emerging AI tools such as Co-Pilot
• Proven superior presentation skills for both clinical and non-clinical audiences
• Proven ability to develop relationships with network and community physicians and other providers
• Proven solid data analysis and interpretation skills; ability to focus on key metrics
• Proven solid team player and team building skills

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Compensation for this specialty generally ranges from $278,000 – $417,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

 

 

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.