Medical Director Specialty Pharmacy Programs Telecommute

Job Description

The Optum Specialty Pharmacy Programs Medical Director will provide utilization management services for our clients and clinical guidance for our next-generation comprehensive specialty pharmacy solution. This solution will help ensure providers deliver high-quality, evidence-based and cost-efficient specialty pharmacy care for our clients.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Serve as a subject matter expert in specialty pharmacy drugs covered under the medical benefit to include for example sodium hyaluronate, inflammatory, intravenous immunoglobulin and multiple sclerosis drugs
• Perform utilization review determinations and support case and disease management teams to achieve optimal clinical outcomes
• Engage & collaborate with treating providers telephonically. This will include discussion of evidence-based guidelines, opportunities to close clinical quality... / service gaps, and care plan changes that can impact health care expense
• Enhance clinical expertise of the specialty pharmacy team through education sessions with nursing teams
• Evaluate clinical and other data (e.g., quality metrics, claims & health record data, utilization data) to identify opportunities for improvement of clinical care and processes

At Optum, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.

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:

• MD or DO with an active, unrestricted medical license
• Board Certified in a Medical Specialty
• 5+ years of clinical practice experience
• Demonstrated accomplishments in any of the following areas: Utilization management, Case management, Disease management, Quality management
• Experience working with clinical policy
• Presentation skills and interpersonal skills
• Computer skills to include MS Office and the ability to learn new technologies
• If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders.

Preferred Qualifications:

• Utilization management experience working in collaboration with a utilization management company, payor or hospital
• Internal Medicine, Family Medicine

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

Colorado Residents Only: The salary/hourly range for Colorado residents is $254,600 to $295,200 (add additional reference for sales and physicians). Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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

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: Medical Director, Specialty Pharmacy, Healthcare, Health Care, Telecommute, Remote, Work from Home, WFH, Internal Medicine, Family Medicine, Internist