Health Services Director – Louisiana Remote

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

Health Service 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. 

Because of the unique structure and alignment of clinical programs within United Healthcare, the HSD role requires a high degree of coordination with external and internal business partners, including, but not limited to the UHC-Clinical Services inpatient and Intake/Prior Authorizations, Appeals and Grievance, Quality, Optum case and disease management, Healthy First Steps, NICU, Behavioral Health, and other clinical specialty, external vendors or national programs.  This position will report to the CEO of Louisiana C&S.

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

Primary Responsibilities:

• Have oversight of Louisiana Clinical operations and the day-to-day activities of their managers and clinical teams and owns the end-to-end process
• Implement program structure and resource plans for Louisiana Medicaid populations serviced under the Healthy Louisiana program run by the Louisiana Department of Health(LDH)
• Ensure clinical processes, policies and procedures meet regulatory standards and are consistent with the national clinical model
• Lead, coach, and develop clinical leadership staff, foster innovation to improve member outcomes
• Identify and drive 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 develop and implement staff retention and engagement program
• Regularly interact with Health Plan Senior leaders and State Regulators on clinical and service issues
• Collaborate with CMO and COO to develop effective clinical strategy for the plan
• 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 plan and lead large scale clinical program deployment and new business implementation
• Manage over 50 FTEs in multiple geographic locations within the state
• Commute to the Metairie and Baton Rouge. LA office locations for meetings

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 RN licensure in State of Louisiana
• 5+ years progressively responsible healthcare leadership
• 5+ years Care Management/Utilization management experience
• Experience working in Medicaid managed care
• Health Plan Experience
• Basic or higher level of proficiency in Microsoft Office Suite including Excel, Work, Outlook, and Access

Preferred Qualifications:

• Case Management Certification
• LTC knowledge
• Louisiana Statewide Medicaid Managed Care program knowledge

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

The salary range for this role is $124,500 to $239,400 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. 

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.    

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.