Community & State CMO - Kansas

Chief Medical Officer (CMO) Opportunity

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UnitedHealthcare is offering an opportunity for a physician to play a critical role on the Community Plan of Kansas's executive leadership team to lead teams and clinical strategy to support the state's most vulnerable populations in achieving healthier lives. The Kansas Health Plan serves over 150,000 Kansans receiving Medicaid and DSNP benefits.

Innovation in healthcare involves transforming the industry through integrated clinical models and value-based provider programs aimed at delivering quality care statewide in Kansas. This role provides continuous career growth opportunities supported by advanced tools, training, and collaboration with skilled colleagues and clinicians.

The CMO role is accountable for ensuring these Kansans 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 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 Regional CMO and national clinical team. The CMO's primary responsibilities are focused on local health plan clinical and business activities as defined by the Health Plan's CEO. The CMO collaborates with other Medicaid markets and regional clinical shared service partners to implement KanCare's managed Medicaid programs. The CMO also collaborates with Medicare clinical teams / CMOs, other markets and regional shared service partners including delegated provider partners to support DSNP programs. Activities support national, regional and local business goals tailored for the Kansas market.

If you are located in Kansas, 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 Kansas Medicaid's clinical leadership team, operations teams, healthcare economics teams and actuaries. The CMO serves as the clinical leader for healthcare affordability initiatives in the local market. Additionally, the CMO is a primary stakeholder in clinical model operations including Person-Centered Care Models (PCCM), Kansas Delivery System Transformation and Value Based Program (VBP) relationships. This includes the design, collaboration, and implementation of new and or improved models of care such as those defined by the State contract, by Centers for Medicare and Medicaid Services (CMS) and the Centers for Medicare and Medicaid Innovation (CMMI). The CMO has oversight responsibility for the local market peer review process as defined by Kansas Medicaid, as well as participating in or leading the regional UHC Peer Review committee.

Clinical Strategy - The Kansas Health Plan CMO is the executive leader that sets the overall clinical strategy for the health plan aligned to business goals and the objective of improving outcomes, access and value for the members we serve. This work includes :

Relationship Equity and State Compliance - The Plan CMO is responsible for acting as the primary medical liaison to state and federal agencies - advocating for beneficial policies, providing expert guidance and shaping healthcare regulations to align with organizational goals

Integrated Care Delivery - The CMO will lead the strategy and guide the execution of integration of behavioral health, physical health, social care services to ensure holistic clinical model for KanCare members. This work includes the entire clinical model (end to end) within the market and the strategic partnerships with the care delivery system in the network to support the clinical model and quality objectives. The Plan CMO leads the clinical interface with providers and UHC network management colleagues in efforts to transform the health system

Growth - The CMO is responsible for defining and delivering the clinical value proposition focused on quality, affordability, and service, in support of growth activities of the Health Plan. The CMO contributes to any RFP / re-procurement activities in the state and plays a critical role defining clinical strategy to support procurement needs. The CMO actively promotes positive relations with State / local regulatory authorities, medical societies, trade associations to ensure our value proposition is well understood. The CMO's engagement, relationships and leadership, the State / local regulatory authorities will come to view the CMO as a trusted thought partner and key advisor on policies, procedures, and practices to improve care for Kansans

Ensure Compliance - The CMO plays a critical role in compliance related activities such :

Demonstrable Skills and Experience :