Director of Delivery System Evolution - Oahu, HI

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The Director of Delivery System Evolution is a local leadership position to directly lead the development and implementation of an integrated care delivery system model as envisioned and required by the State of Hawaii Medicaid program. The vision by the State of Hawaii is set forth in their "HOPE" document specifically the "Hale Ola" which will be delegated provider systems focused on the underserved including medically fragile and those with special health care needs and chronic conditions. This position will be a strategic leader for the health plan and position UnitedHealthcare to influence the State of Hawaii, providers and other health plans to put into practice the vision of the State and adoption of our model. This Director will be a distinctive advantage for UnitedHealthcare in the Medicaid re-procurement and a competitive edge in the next contract.

Primary Responsibilities:
  • Develops and implements the Hawaii Integrated Delivery System Model ("HIDSM") to meet the State's Medicaid program vision for the Hale Ola as set forth in the HOPE and RFP documents. The model will reflect UnitedHealthcare's approach and design including VBC and delegation of care management
  • As the accountable owner - develops, implements and puts into practice the HIDSM:
    • Works with various leaders and teams within UnitedHealth Group including network, clinical, ACO, quality, and behavioral health
    • Works with external organizations and agencies including providers, CBOs, health plans, associations (e.g. hospitals), State agencies, and HIE(s)
  • Leads collaborative efforts to ensure contracting, clinical care delegation, information technology, reporting, delegation oversight, quality metrics and other required components of the HIDSM are structured and operationalized correctly and efficiently
  • Leverages information system resources internally and externally to ensure success of the HIDSM including necessary clinical and quality information and data, SDOH data and information, as well as use of HIEs such as the Hawaii Health Information Exchange and provider system interfaces
  • Reporting and metrics to track and measure success of the HIDSM
  • Provide guidance and expertise to other markets to leverage HIDSM across the enterprise where feasible and appropriate

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:
  • 5+ years of experience working with providers in a management care environment, or within a health system, in a network contracting, provider servicing, value-based contracting, provider relations or related role
  • Experience working in a matrix environment across departments such as network, accountable care, field clinical teams, or related
  • Demonstrated leadership qualities including, but not limited to: leading projects, leading others, and/or project management
  • Must be locally based on the island of Oahu, or willing to relocate
  • Experience working with, or within, an accountable care organization
  • 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

Preferred Qualifications:
  • Healthcare experience in the Hawaii market
  • Experience with claims, quality, utilization management, health plan operations, behavioral health and/or healthcare finance
  • Strategic thinker, excellent communication and presentation skills

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

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)

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: Provider Contracting, Network Contracting, Provider Relations, Quality, Utilization Management, Accountable Care, ACO, HIDSM, Medicaid, Hawaii Integrated Delivery System Model, Value-Based Contracting, Hawaii Medicaid, Oahu, UHC, UnitedHealthcare