[Hiring] DSNP Executive Director @UnitedHealth Group

Role Description

As the Executive Director, Dual Special Needs Plan (DSNP ED), you will manage a complex, innovative, and growing product line in collaboration with local Market Medicaid leadership and our nationally leading Medicaid team. The DSNP ED role will focus on delivering overall product results, including:

• Growth
• Medical expense and revenue management
• Quality and clinical outcomes
• Integration and coordination of Medicaid and Medicare benefits

You will be accountable for developing deep state relationships to support the annual State Medicaid Agency Contracts (SMAC) Process and shaping state Medicaid strategy for integration and benefit coordination. This role requires deep knowledge of local community-based supports and demonstrated relationships with local Community Based Organizations (CBO) and Medicaid service organizations.

The successful candidate will have a deep understanding of both Medicaid and Medicare, including:

• How these programs work together to promote health and wellbeing for the most vulnerable
• Ability to work in a matrixed environment
• Collaborative goal setting with local market CEO and national product team leaders

The DSNP ED will also be responsible for:

• Fostering relationships with local community supports and providers
• Driving solutions and partnerships to increase STARS rating of health plans
• Improving access to care in the communities served

If you reside locally to New Jersey, you will have the flexibility to work remotely.

Qualifications

• 4+ years of experience in Medicaid and/or Medicare programs environment, care delivery models, VBC/APMs
• Experience in quality improvement, strategic planning and development
• Experience designing and/or administering health programs and developing health care policy
• Experience managing high-profile community projects or large-scale contracts
• Consistent, progressive leadership experience in health care delivery and public programs
• In-depth knowledge of the dual Medicaid – Medicare eligible populations including Behavioral Health and LTSS
• People management, including direct supervisory experience
• Ability to travel up to 75%
• Reside locally to New Jersey

Requirements

• Direct oversight of the Dual Special Needs Plan (D-SNP) for multiple states
• Ensures compliance with applicable state and Federal laws and contractual obligations
• Product P&L ownership and leadership across a complex organization
• End-to-end ownership of all related functions for assigned D-SNP markets
• Collaboration with Government Programs functional teams
• Maintain awareness of and apply emerging state and federal policy requirements
• Develop and execute strategic priorities related to Highly Integrated Dual Eligible (HIDE) & Fully Integrated Dual Eligible (FIDE) maturation
• Defines strategic priorities to support contract, SMAC, Risk Adjustment Factor (RAF), STARS and other quality standards
• Works closely with UHN partners to refine the DSNP network for optimal success
• Assists in detecting service problems and coordinating solutions
• Participates in formulating and administering company policies
• Establishes and maintains an excellent business reputation
• Continuously fosters innovation, improvement and positive differentiation in the assigned markets

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (subject to eligibility requirements)