Job Description
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 Caring. Connecting. Growing together 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. 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. 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% within the VA Market as you take on some tough challenges. Primary Responsibilities: Operational Leadership & Execution 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 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 Translate enterprise strategy and DMAS commitments into clear operational priorities, workflows, performance metrics, and accountability structures Ensure operational consistency and scalability across regions while supporting local engagement and region specific execution aligned with DMAS expectations Regulatory Compliance & Audit Readiness Maintain operational readiness for DMAS, CMS, EQRO, operational, and financial audits, ensuring timely, accurate, and coordinated responses Partner with Compliance and Legal to embed contract compliant processes, internal controls, and monitoring into daily operations Support ongoing review and implementation of contract amendments and policy updates in coordination with DMAS Clinical & Care Delivery Operations (Operational Oversight) 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 Collaborate with the CMO and clinical leaders to ensure operational infrastructure supports quality improvement, clinical outcomes, and member experience goals Network, Member & Provider Operations Oversee operational functions supporting provider network performance, member services, grievances and appeals, enrollment support, and service delivery performance Ensure operations are structured to support provider engagement, timely issue resolution, and service accessibility across all regions of the Commonwealth Performance Management & Continuous Improvement Establish and monitor operational KPIs, dashboards, and management routines tied to quality, compliance, financial stewardship, and stakeholder satisfaction Lead continuous improvement initiatives to enhance efficiency, reduce operational risk, and improve service reliability while maintaining compliance People, Culture & Cross Functional Leadership Lead, mentor, and develop operational leaders, fostering a culture of accountability, collaboration, and operational excellence Promote solid cross functional integration between operations, clinical, compliance, finance, and shared services External & Stakeholder Engagement 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 Build, develop, improve, influence and expand relationships with providers, community-based organizations/partners, and other sta