Chief Medical Officer - UHC Community Plan of Tennessee

Company: UnitedHealth Group
Location: Brentwood
Posted on: May 3, 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 is offering an opportunity for physicians to lead teams in Tennessee to support the state's most vulnerable population in achieving healthier lives. UnitedHealthcare strives to improve lives through various healthcare initiatives while providing career-building opportunities.Innovation in healthcare involves transforming the industry through integrated clinical models and value-based provider programs aimed at delivering quality care statewide in Tennessee. This role provides continuous career growth opportunities supported by advanced tools, training, and collaboration with skilled colleagues. With the support of the latest tools, advanced training, and the collaboration of skilled colleagues, you can continue your professional journey as the Chief Medical Officer (CMO) for UnitedHealthcare Community Plan of Tennessee.This Community and State (C&S) Health Plan serves over half a million Tennesseans receiving Medicaid benefits. The CMO role is accountable for ensuring these Tennesseans 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 over 3,000 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 C&S CMO as well as to the Enterprise Clinical Services (ECS) Regional CMO. The CMO's primary responsibilities are directed towards local C&S plan activities as defined by the Health Plan's CEO. The CMO collaborates with ECS staff including the regional CMO, and other market and regional shared service partners to implement the State of Tennessee's TennCare programs for its managed Medicaid Program. Activities support national, regional and local business goals tailored for the Tennessee Medicaid market.If you are located in Tennessee, 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 Bureau of TennCare's clinical leadership team, ECS operations teams and with UnitedHealthcare's national healthcare economics team.
• Clinical Excellence: The Tennessee Health Plan CMO supports the HEDIS and STARs data collection process, CAHPS improvement strategy, and drives Health Plan accreditation activities.
• Relationship Equity and State Compliance: The Plan CMO maintains a solid working knowledge of all government mandates and provisions for the Tennessee Medicaid market.
• Innovation: The Plan CMO leads the clinical interface with care providers and UHC network management colleagues in efforts to transform the health system.
• Growth: The CMO delivers the clinical value proposition focused on quality, affordability, and service, in support of growth activities of the C&S Health Plan.
• Grievance and Appeals: The Plan CMO maintains an active liaison with ECS Grievance & Appeals and is responsible for leading a clinical team overseeing and or representing the Local C&S plan at state-level fair hearings at the state's request.Demonstrable Skills and Experience:
  • Ability to build a team that values organizational and health plan success over personal success.
  • Ability to focus staff on the company's mission and inspire superior performance.
  • Ability to drive disciplined fact-based decisions.
  • Ability to execute with discipline and urgency; drive exceptional performance.
  • Ability to drive change and innovation through continually seeking and implementing innovative solutions.
  • Ability to model and demand integrity and compliance.
  • Proven ability to execute and drive improvements against stated goals.
  • Ability to develop relationships with Tennessee State government clinical leadership.
  • Ability to be visible and be involved in the medical community.
  • Ability to successfully function in a matrix organization.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.
    • Develop and mentor others while also building awareness of 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.
    • Lead change and innovation by demonstrating emotional resilience.
    • Drive sound and disciplined decisions that drive action.
    • Drive high-quality execution and operational excellence.
    • Manage execution by delegating work to maximize productivity.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 Tennessee medical license as a Doctor of Medicine (MD) or Doctor of Osteopathy (DO).
      • Board Certified in one or more of Internal Medicine, Family Medicine, Pediatrics, OB/GYN, or Psychiatry.
      • Current DEA licensure and prescriptive authority in the state where applicable.
      • 5+ years of clinical practice experience.
      • 2+ years of Quality Management experience.
      • Solid knowledge of managed care industry and the Medicaid line of business.
      • Proven solid leadership skills.
      • Proven excellent interpersonal communication skills.
      • Proven excellent project management skills.
      • Proven solid data analysis and interpretation skills.
      • Proven solid team player and team building skills.
      • Proven strategic thinking with proven ability to communicate a vision.
      • Proven solid negotiation and conflict management skills.
      • Proven creative problem-solving skills.
      • Reside in greater Nashville, Tennessee area.
      • Willing or ability to travel 25% throughout Tennessee.Preferred Qualifications:
        • Master's degrees in public health, business administration and or HealthCare Administration.
        • Familiarity with current medical issues and practices.
        • Proficiency with Microsoft Office applications.
        • Proven ability to develop relationships with network and community physicians.
        • Proven superior presentation skills for both clinical and non-clinical audiences.*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.The hourly range for this role is $343,500 to $516,500 per hour based on full-time employment. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. 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).At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone...UnitedHealth Group is an Equal Employment Opportunity employer under applicable law...UnitedHealth Group is a drug-free workplace...
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Keywords: UnitedHealth Group, Clarksville , Chief Medical Officer - UHC Community Plan of Tennessee, Executive , Brentwood, Tennessee