UnitedHealthcare Market Chief Medical Officer - Employer & Individual - California
Company: UnitedHealth Group
Location: Concord
Posted on: June 1, 2025
Job Description:
At UnitedHealthcare, 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 equitable.
Ready to make a difference? Join us to start Caring. Connecting.
Growing together.UnitedHealthcare's Market CMOs serve as the local
senior clinical executive for their line of business, with
accountability for:
- Achieving defined clinical outcomes, affordability goals and
growth targets, in partnership with their health plan leadership
team
- Provide clinical insight into market data and implementing
tailored interventions to address clinical trends and opportunities
for their state or region
- Serving as a central health plan leader accountable to
facilitate coordination with UnitedHealthcare and Optum national
clinical and operational functions
- Actively engage and help drive performance with market-level
quality, network, and compliance teams
- Building and deepening relationships with area hospitals,
physicians, and other health care providers
- Advocate for UnitedHealthcare's clinical value story,
evidence-based medical policies, and member health with
government/state regulatory entities, professional and medical
society chapters, employers, and as part of external communications
and media relations
- Provides subject/specialty based clinical expertise and
leadership to UCS and the enterprise, as neededYou'll enjoy the
flexibility to work remotely * from anywhere within the U.S. as you
take on some tough challenges.Primary Responsibilities:
- Clinical Affordability - CMOs are responsible for achieving
their assigned incremental savings goal and support the national
savings target for the year. Driving savings is a two-pronged,
data-driven approach of local response and national implementation,
where CMOs lead targeted clinical inventions to address local
market trends and needs, and support on-the-ground alignment with
national utilization management programs. Inform and drive local
and national affordability initiatives: CMOs are expected to apply
healthcare economics insights and escalate local issues and
trends
- Network / Provider Engagement - The CMO serves as the local
clinical point of contact for physicians, systems, and other care
providers and with UnitedHealth Networks colleagues. Key activities
include UHC's Accountable Care Platform, value-based contracting,
clinical practice transformation, patient-centered medical homes,
and transparency initiatives such as UnitedHealth Premium
Designation and/or High Performing Physicians. The CMO meets
regularly with hospitals and physician groups and shares data on
quality and efficiency improvement opportunities and developing
action plans for sub-optimal results
- Market Relationships - The CMO is the clinical face of
UnitedHealthcare to elected officials, policy makers, plan
sponsors, medical and professional societies, news media, and
community-based organizations. The CMO is engaged in regular,
proactive dialogue with our external constituents to advance
evidence-based medicine and support best practices in health care
delivery
- Quality & Compliance - The CMO maintains a solid working
knowledge of all government mandates and provisions, working across
the enterprise to implement and maintain compliant clinical
programs and procedures. The CMO also supports quality improvement
efforts as measured by CMS Star Ratings, NCQA Star Ratings, HEDIS,
CAHPS, HOS and other national and company metrics. The CMO partners
with UHC Compliance to ensure clinical management regulatory
obligations regarding clinical management are met. Market CMOs also
chair required Quality Oversight Committees at a market/regional
levelYou'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/unrestricted California Medical License
- Active/unrestricted Board Certification in an ABMS or AOBMS
specialty
- 5+ years clinical practice experience
- Ability/experience in developing collaborative relationships
with health system clinical leadership
- Solid knowledge of managed care industry
- Solid knowledge of health care utilization data and
analytics
- Familiarity with current medical issues and practices
- Proficiency with Microsoft Office applications (Outlook, Word,
Excel, PowerPoint)
- Proven excellent interpersonal communication skills and ability
to influence in executive settings
- Proven superior presentation skills for both clinical and
non-clinical audiences
- Proven ability to identify an improvement opportunity through
data, implement a solution and achieve measurable impact. Solid
data analysis and interpretation skills; KPI metrics driven.
- Proven ability to develop relationships with network and
community physicians and other providers
- Proven ability to travel within the assigned market-30% travel
required
- Proven capable to quickly become facile with UHC/UHG specific
data systemsPreferred Qualifications:
- Advanced Business, Public Health, Medical Management
degree
- Health plan experience in similar leadership capacity
- 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*All employees working
remotely will be required to adhere to UnitedHealth Group's
Telecommuter PolicyThe salary range for this role is $343,500 to
$516,500 annually based on full-time employment. Pay is based on
several factors including but not limited to local labor markets,
education, work experience, certifications, etc. UnitedHealth Group
complies with all minimum wage laws as applicable. In addition to
your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching
choice of benefits and incentives.Application Deadline: This will
be posted for a minimum of 2 business days or until a sufficient
candidate pool has been collected. Job posting may come down early
due to volume of applicants.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.
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Keywords: UnitedHealth Group, Novato , UnitedHealthcare Market Chief Medical Officer - Employer & Individual - California, Executive , Concord, California
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