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Chief Executive Officer, New Jersey Health Plan (C&S) - Edison, NJ

UnitedHealth Group


Location:
Edison, NJ
Date:
05/26/2017
Job Code:
1744967
Apply on the Company Site
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Job Details


Chief Executive Officer, New Jersey Health Plan (C&S) - Edison, NJ(Job Number:713280)
Description

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work. (sm)

The Chief Executive Officer, New Jersey Health Plan (UHC Community & State) directs the strategic development, growth and operations of the New Jersey health plan. This role has overall accountability to meet revenue, membership and operating income objectives, develop key provider affiliations, establish an influential relationship with the state, direct and effectively develop strategic goals into specific business plans, and create a successful, collaborative team of people to achieve these goals.   

This role is critical to serving as the 'account manager' for the State of New Jersey relationship, managing all aspects of profit-and-loss, driving overall performance, leading strategic planning and managing a state-based operation through a matrix team. Working closely with the UnitedHealthcare Community and State Leadership Team, the Health Plan CEO will become familiar with the established vision, mission and strategies of the organization and will build on these to effectively define, articulate and address the current and future needs and priorities of the local market.   They will effectively lead a team that is focused on making a difference for our members and our state partners.  


Responsibilities:

Develop/Lead/Execute Market-Specific Health Plan Strategies and Programs

•Direct the strategic development, growth and operations of the health plan in providing innovative care

•Develop and execute a forward-looking multi-year Health Plan strategy, including priorities and programs that will drive business growth to meet customer, financial and performance expectations and commitments

•Ensure commitment/support for health plan strategies and programs from internal and external stakeholders

•Foster state/local relationships (e.g. communication, engagement & identification) to identify and drive potential merger and acquisition opportunities to grow the Medicare/Medicaid business

•Demonstrate innovation in evaluating, funding and pursuing productive market opportunities (e.g., apply an entrepreneurial venture-capitalist mindset, perform financial analyses to identify opportunities)

•Articulate market-specific strategies and plans with a focus on sustainable, profitable growth

•Identify and drive adoption of innovative contracting and payment strategies/approaches, as appropriate (e.g., next-generation contracting, ACOs)

•Build commitment and support of matrix partners on the execution of shared business/enterprise goals

•Lead the strategic direction and decision-making for RFP bid processes as required, in order to drive business growth

•Lead the government sector in industry reform and business growth

•Drive the gathering of competitive market intelligence, and ensure that appropriate action is taken (e.g., understand our place in the market, proactively act on industry opportunities and threats, determine how to position our business for continued success to drive competitive advantage and differentiation in the marketplace).

Drive Health Plan Efficiency, Quality and Financial Performance

• Utilize stakeholder input to help shape and implement continuous improvement in operational quality and financial performance

• Understand and manage multiple levers of health plan profitability (e.g. rate advocacy, member retention, utilization management, Star performance & Medicaid Quality)

• Ensure internal partners and/or external vendors adhere to business and contractual agreements

• Ensure that business continuity/emergency response plans are reviewed and tested regularly, up-to-date, and can be readily executed

• Utilize relevant systems and tools to identify and/or test opportunities for efficiency improvements (e.g., parallel variable testing)

• Demonstrate understanding of the meaning and implications of key financial indicators

• Build, understand and adjust health plan forecasts, and balance priorities to meet business commitments

• Analyze health plan performance on relevant criteria

• Lead education of functional partners (e.g., clinicians, healthcare economics, claims payment, external vendors, care managers, provider network) to develop, implement, and/or drive health care quality and affordability initiatives

• Analyze budget performance and variances throughout the fiscal year, and recommend and/or make necessary adjustments and corrections

• Work with relevant internal partners (e.g., Finance, Actuaries) to identify resource requirements and/or create budgets and forecasts

• Ensure regularly scheduled and impactful market reviews with participation from applicable business partners (e.g., Underwriting, Network, Clinical and Specialty Products, Operations, Regulatory, Product, and Marketing)

• Review and assign projects/initiatives based on resource capacity, capability, and expertise

• Conduct deep-dive reviews with relevant internal and/or external stakeholders to identify opportunities for continuous improvement

Build, Maintain and Manage Relationships with Internal and External Stakeholders

• Build strong relationships with the State that drives the organization to deliver industry-leading customer service and satisfaction through the Net Promoter Score

• Focus on external relationships to understand, influence and adapt to the changing landscape

• Build, develop, improve, influence and expand relationships with key government sector customer groups, providers/provider networks within the market, and government and regulatory stakeholders (e.g., local and state government, public policy leaders, lobbyists, regulatory bodies, government affairs, public policy leaders)

• Identify, develop and partner with relevant internal and/or external stakeholders to develop and/or review potential health plan strategies, programs, and plans (e.g., affordability initiatives, quality programs, projected resource needs)

• Interact with applicable stakeholders affecting government sector programs (e.g., state agencies, providers, media, faith-based organizations) to answer questions, respond to inquiries, and/or drive and affect change and growth

• Drive strong brand recognition and reputation within the market and community

• Build, develop, improve, influence and expand relationships with business leaders across UnitedHealth Group to ensure positive outcomes in the local market

• Represent the goals of the market to internal and external constituents across all lines of business to achieve solutions in the interests of the enterprise

• Influence state and community partners on company capabilities, tools, and processes that can be leveraged to improve delivery service and quality

• Position health plan for procurements and re-procurements

Drive Industry Leading Consumer, Customer and Provider Satisfaction

• Model a continuous focus on maximizing the member, customer and provider experience

• Drive the organization to deliver value beyond customer expectations

• Drive organizational focus on customers and those who serve customers

• Gather and analyze feedback from customers to identify new/emerging needs and make appropriate changes to Health Plan strategies and programs

• Identify and/or pursue potential business opportunities with new and/or existing business partners to strengthen/optimize networks in order to achieve business objectives

• Leverage resources from other parts of the enterprise to provide cost-effective, comprehensive customer solutions

• Ensure a coordinated approach to provide a more seamless face to our customers

• Represent the organization as the face of UnitedHealthcare with external market entities

• Seek feedback from customers to determine success of overall strategy/program management and implementation

• Build and work with advocacy groups to ensure alignment with business strategy

• Influence policy by presenting to relevant organizations (e.g., trade organizations and associations, fairs, conferences, hospital associations) regarding government sector programs

Drive Best-in-Class Operational and Clinical Performance (C&S)

• Drive world-class operational and clinical performance for critical processes such as, contractual, compliance and regulatory, grievance and appeals, utilization management, call and claim and enrollment

• Influence commitment to ensure obligations are met through data analysis and strategic plans

• Innovate and explore new ways to exceed member experience and affordability while ensuring compliance



Job Executive Leadership Team
Primary Location US-NJ-Edison
Other Location 
Organization C&S New Jersey
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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