Medical Director careers at UnitedHealth Group are anything but ordinary. We push ourselves and each other to find smarter solutions. The result is a culture of performance that's driving the health care industry forward. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Join us. And start doing your life's best work.(sm) Florida LTC program goal and mission is to help member's live healthier lives in the least restrictive environment providing them with all the necessary services to remain there. We have an exciting, new opportunity for an experienced Nurse Executive to lead the Medicaid Long Term Care Clinical Team in our Health plan. Our statewide Health Services Director - Long Term Care Operations executes the delivery of all clinical programs and ensures positive clinical and operational results are delivered in a manner consistent with the principles and philosophy of UnitedHealthcare. If you are commuting distance to Miramar, FL, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities:Have oversight of the Regional Health Services Directors and the day to day activities of their managers and clinical teams and owns the end-to-end process This position will report in to the Executive Director of the LTC program Implement program structure and resource plans for Long Term Care populations serviced under the SMMC program in FL Ensure clinical processes, policies and procedures meet regulatory standards and are consistent with the national clinical model Lead, coach, and develop clinical leadership staff, fosters innovation to improve member outcomes Identify and drives local Healthcare affordability initiatives along with medical directors and clinical teams Ensure monitoring and oversight of clinical programs/staff to meet defined goals, targets and regulatory requirements Work collaboratively with providers, other business segments, service contractors and health plan management to oversee health services department with the objectives of improving the quality of care delivered to members, improving cost efficiencies, and developing an environment of operational excellence Interface with UHG enterprise to ensure clinical operations are compliant with State and Federal regulations. Collaborate with internal and external entities to improve accessibility standards and quality practice standards Develop, interpret and execute strategies or functional / operational objectives for Health Plan including medical management, financial accountability, customer and provider satisfaction and quality improvement Proactively develops and implements staff retention and engagement program Regularly interacts with Health Plan Senior leaders and State Regulators on clinical and service issues Ensure clinical staff training, on boarding, immersion and competency assessment processes meet contract requirements and clinical model standards Coordinate and provide oversight for all clinical programs delivered by multiple business segments / external vendors to ensure Health Plan goals are met Identify and implement best practices, barriers and potential solutions when operational processes or clinical programs are not delivering results Effectively plans and leads large scale clinical program deployment and new business implementation Ability to manage over 300 FTEs in multiple geographic locations within the state Ability to commute to the Miramar, FL office location for meetings
Required Qualifications:Active RN licensure in State of Florida Bachelor's degree in Nursing 5+ years progressively responsible healthcare leadership Significant experience in development and execution of clinical programs in public sector managed care environment (2+years) LTC knowledge Proficient in Microsoft Office Suite including Excel, Work, Outlook and AccessPreferred Qualifications: Master's degree in business, nursing or related field Florida Statewide Medicaid Managed Care program knowledge If the hired individual resides in Florida (office based or telecommuting) this position requires the AHCA Level II background check (fingerprinting) by the State of Florida for all clinicians that have direct face to face contact with members OR employees who will have access to confidential patient data and will require renewal every five years. 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) *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.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. Job Keywords: Long term care, medical director, Florida, FL, Miramar, Jacksonville, Maitland
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.