Chief Operations Officer - Telecommute, Brentwood, TN

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM


Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

The Chief Operating Officer is accountable for the successful delivery of the health plan's operational performance; ensuring state's contractual requirements are consistently met/exceeded. This is achieved through the daily collaboration, management and/or oversight of matrix partners, various levels of staff, as well as multiple functions / departments within the health plan. This role will be called upon to leverage strong leadership experience managing across matrix partners to drive and ensure performance delivery.

The COO serves as a key contact for TennCare and the Tennessee Department of Commerce and Insurance (TDCI) partnerships and inquiries, oversight and meeting with providers individually as well as joint operating committees. This role will oversee the relationship management with our external provider partnerships, as well as with our internal matrix partners, to include Operational Shared Services (Claims Provider Operations, Call Centers, etc) as well as with Optum (behavioral health, payment integrity, and analytics). The COO drives that vision and strategy for the design, coordination and completion of operational implementation and optimization projects across various functional areas within UnitedHealthcare. The COO will oversee various departments' performance and effect change as needed to improve service, simplify work flow and assure compliance with regulatory requirements. They will effectively lead a team that is focused on making a difference for our members, our providers, our team members and our state partners.

If you are located within commutable distance of Nashville, Tennesee, you'll enjoy the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:
  • Sets business direction, develops, implements and oversees operational performance across Health Plan Team and supporting Matrix to meet TennCare's contractual requirements, as well as the unique needs of the Tennesseans whom we serve and our provider community
  • Accountable for the successful delivery of state defined operational service levels via clear operating metrics managed via daily, weekly and monthly scorecards to confirm contractual compliance
  • Oversees and manages vendors, as well as functional partners
  • Provide subject matter expertise in project management, project scope definition, risk identification, project methodology, resource allocation and other areas of expertise
  • Lead, coordinate and complete operational improvement projects across various functional areas within UnitedHealthcare
  • During state program implementations, will verify that all new operational policies, procedures and desktops are in place according to contract requirements. Verifies readiness through testing and evaluation
  • Develops collaborative relationships with and confirms business partners can execute day-to-day responsibility for operations (member services center, enrollment, claims, encounters, reporting, technology, etc.)
  • Develops collaborative relationships with Optum, across multiple service offerings
  • Informs and advises management regarding State's current trends, problems and activities to facilitate both short- and long-range strategic plans to improve operational performance and enhance growth
  • Owns accountability for state reporting metrics, accuracy, and timeliness
  • Owns operational accountability for the successful system conversions, where applicable
  • Anticipates, identifies and resolves technical, operational and organizational problems inside and outside health plan
  • Provides governance on network strategy and development
  • Leads teams to resolve business problems that affect multiple functions or disciplines
  • Provides leadership to and is accountable for the performance and direction with all levels of management and senior level professional staff
  • Deliver value to members by optimizing the member experience and maximizing member growth and retention
  • Lead and influence Health Plan employees by fostering teamwork and collaboration, driving employee engagement and leveraging diversity and inclusion
  • Lead change and innovation by demonstrating emotional resilience, managing change by proactively communicating the case for change and promoting a culture that thrives on change
  • Drive sound and disciplined decisions that drive action while effectively using financial knowledge and data to manage the business
  • Drive high-quality execution and operational excellence by communicating clear directions and expectations

This position has conditions onsite work within Nashville, TN area. Travel for this role will be limited and within Tennessee as needed.

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.

Required Qualifications:
  • Bachelor's degree in Health Care Administration, Business or Management or related field OR equivalent experience
  • 7+ years of operations leadership experience in a Medicare/Medicaid, at-risk managed care environment
  • 5+ years of people leadership experience in a Managed Care or payer operations environment
  • 5+ years of provider contracting and/or provider operations experience
  • 3+ years of experience in a senior leadership capacity
  • Technical and financial knowledge of and experience with health care operations
  • Experience with advising IT resources related to enterprise platform initiatives, providing direction on platform implementation and/or migrations
  • In depth understanding of challenges that face health plans and health care in general
  • Solid analytical and problem-solving skills
  • Ability to evaluate outcomes based upon qualitative and quantitative measures and adjusts accordingly
  • Proven negotiation and influencing success within a highly matrixed organization

Preferred Qualifications:
  • Master's degree in Health Care Administration, Business or Management or related field
  • NCQA experience
  • Experience with TennCare Medicaid program
  • Vendor and contract management experience
  • Value Based Reimbursement Programs
  • Exceptional leadership skills and operational management expertise
  • Excellent written and verbal communication skills
  • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Colorado, Connecticut or Nevada Residents Only: The salary/hourly range for Colorado residents is $110,200 to $211,700. The salary/hourly range for Connecticut/Nevada residents is $110,200 to $211,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

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.

Job Keywords: Chief Operations Officer, Executive Director, COO, Chief Operations Officers, Health Plan Executive, Health Plan Leader, Telecommute, Telecommuting, Telecommuter, Brentwood, TN, Tennessee