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About the Role

The VP of Government Programs Clinical Programs & Operations is responsible for developing and executing clinical programs and operations for Government program members in Dual-Eligible, Medicare, and Medicaid programs. This role manages a $3B+ clinical budget, oversees program design, training, IT development, clinical compliance, and workforce management for over 5,000 clinical FTEs. The VP will also be the clinical executive owner for M&A due diligence and RFP responses.

Responsibilities

Leads development of the clinical programs and operations annual business plan and contributes to business plans for Community & State and Medicare & Retirement.
Translates strategic plans into team goals and leads the design of practical plans for market execution.
Supports investment prioritization and funding requests, including ROI, risk, and financial analysis inputs.
Provides strategic input on the external clinical program landscape and payment reform trends.
Drives end-to-end integration across member and provider touch points to create a single, holistic clinical model.
Works across the enterprise to drive alignment of medical and behavioral health services, network, and operations.
Supports the management of the government programs clinical portfolio to improve competitive position and performance.
Responsible for the design, development, management, or sun-setting of new or existing programs.
Designs tools to monitor program effectiveness across markets and partners with health plan leadership to implement performance-driving changes.
Leads and drives large-scale initiatives across Government Programs, assists with vendor and program governance, manages interdependencies, and estimates/allocates resources.
Executes against strategic, tactical, and operational goals in partnership with market, regional, and national leadership.
Partners with key operations and support teams to define program requirements and expected benefits, ensuring contractual and service level agreements are met.
Develops and maintains procedures to support clinical policies, quality, and growth.

Requirements

Executive leader with 10+ years of demonstrated progressive career accomplishments, including senior leadership roles.
7+ years of health industry experience.
Expert at strategic conceptualization at both local and national organizational levels.
Strong negotiation, problem-solving, planning, and decision-making skills.
Ability to accurately scope projects, set objectives and goals, develop schedules and resource assignments, measure performance, and evaluate results.
Demonstrated ability to lead business initiatives to successful outcomes.
Excellent communication skills, including presenting ideas, selling concepts, effective executive communication, understanding needs, and driving change management.
Proven cross-functional influence and relationship-building skills, with a willingness to lead initiatives and structure approaches to new opportunities.
Ability to effectively deal with ambiguity, cope with change, shift gears comfortably, decide and act without having the total picture, and handle risk and uncertainty.
Demonstrated leadership and hands-on experience, with the ability to mentor talent, provide work direction, and attract/retain top talent.

Skills

Clinical program design
Population health
Management of large-scale clinical operations
Understanding of Medicaid and Medicare populations, policy, state programs, and government businesses
Clinical experience (RN, MSN) in a care management or utilization management structure

Location

Remote (U.S.)
Minneapolis (Hybrid)
Washington D.C. (Hybrid)

Work Type

Remote
Hybrid

Experience Level

Senior leadership
Executive

Education Level

Salary/Compensations

$200,400 to $343,500 annually

Benefits

Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution

About the Company

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.
We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life.
We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Equal Opportunity

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.