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Chief Operating Officer (COO) - Virginia Community & State Medicaid Health Plan - Remote
<p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start <strong>Caring. Connecting. Growing together</strong></span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><strong> </strong></span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">The Chief Operating Officer (COO) serves as a key member of the executive leadership team and is responsible for the day to day operational performance of the health plan, ensuring consistent execution of the Cardinal Care Managed Care Contract with the Virginia Department of Medical Assistance Services (DMAS). This role provides enterprise wide leadership across operations, clinical delivery support, network operations, compliance execution, and operational readiness—translating strategy into disciplined, reliable operations that deliver high quality, compliant, and member centered outcomes across the Commonwealth of Virginia.</span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"> </span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">The COO partners closely with the CEO, Chief Medical Officer, Chief Financial Officer, Chief Compliance Officer, and functional leaders to ensure operational excellence, audit readiness, and solid performance against contract, quality, financial, and stakeholder expectations under Cardinal Care.</span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"> </span></p><p style="text-align:center;"><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><strong>You’ll enjoy the flexibility to work remotely* from anywhere within the U.S., preferably in VA, as you will be required to travel 50%25 within the VA Market as you take on some tough challenges. </strong></span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><strong> </strong></span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><strong>Primary Responsibilities: </strong></span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Operational Leadership & Execution</span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Leads relationship management on all Operations related areas for the Cardinal Care program with the DMAS and all other State government agencies who have regulatory oversight of elements of the Cardinal Care/DSNP program to influence program design, develop support for program efforts, and secure approvals</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Lead and oversee core health plan operations (provider & member related, network, IT, claims, etc.) ensuring effective implementation of all Cardinal Care contract requirements across covered populations, regions, and services</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Translate enterprise strategy and DMAS commitments into clear operational priorities, workflows, performance metrics, and accountability structures</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Ensure operational consistency and scalability across regions while supporting local engagement and region specific execution aligned with DMAS expectations</span><br> </li></ul><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Regulatory Compliance & Audit Readiness</span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Maintain operational readiness for DMAS, CMS, EQRO, operational, and financial audits, ensuring timely, accurate, and coordinated responses</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Partner with Compliance and Legal to embed contract compliant processes, internal controls, and monitoring into daily operations</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Support ongoing review and implementation of contract amendments and policy updates in coordination with DMAS</span><br> </li></ul><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Clinical & Care Delivery Operations (Operational Oversight)</span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Provide operational oversight and support for care management, care coordination, behavioral health integration, LTSS operations, and population specific programs, ensuring alignment with Cardinal Care delivery models</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Collaborate with the CMO and clinical leaders to ensure operational infrastructure supports quality improvement, clinical outcomes, and member experience goals</span><br> </li></ul><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Network, Member & Provider Operations</span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Oversee operational functions supporting provider network performance, member services, grievances and appeals, enrollment support, and service delivery performance</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Ensure operations are structured to support provider engagement, timely issue resolution, and service accessibility across all regions of the Commonwealth</span><br> </li></ul><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Performance Management & Continuous Improvement</span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Establish and monitor operational KPIs, dashboards, and management routines tied to quality, compliance, financial stewardship, and stakeholder satisfaction</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Lead continuous improvement initiatives to enhance efficiency, reduce operational risk, and improve service reliability while maintaining compliance</span><br> </li></ul><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">People, Culture & Cross Functional Leadership</span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Lead, mentor, and develop operational leaders, fostering a culture of accountability, collaboration, and operational excellence</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Promote solid cross functional integration between operations, clinical, compliance, finance, and shared services</span><br> </li></ul><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">External & Stakeholder Engagement</span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Serve as a senior operational liaison to DMAS and other state partners as appropriate, supporting clear communication, issue resolution, and trusted relationships in partnership with the CEO and executive team</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Build, develop, improve, influence and expand relationships with providers, community-based organizations/partners, and other stakeholders within the market and foster collaborative partnerships</span></li></ul><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"> </span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">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.</span></p><br><br><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><strong>Required Qualifications: </strong></span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">5+ years of experience working with FQHCs, Community Based Organizations, and State regulatory agencies</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">5+ years of experience working in Managed Medicaid</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">5+ years of experience leading operations, strategic planning, and development</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Ability to handle ambiguity</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Ability to travel up to 50%25 throughout the State of VA</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Driver’s License and access to reliable transportation</span></li></ul><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><strong> </strong></span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><strong>Preferred Qualifications: </strong></span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Executive level experience in dealing with multiple State Agencies</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Reside in Virginia </span></li></ul><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"> </span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy </span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"> </span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $159,300 to $273,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.</span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.</span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"> </span></p><p style="text-align:center;"><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><i>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. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. 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. </i></span></p><p style="text-align:center;"><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><i> </i></span></p><p style="text-align:center;"><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><i> </i></span></p><p style="text-align:center;"><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><i>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. </i></span></p><p style="text-align:center;"><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><i> </i></span></p><p style="text-align:center;"><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><i>UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. </i></span></p>