Medical Director - Specialty Pharmacy - Remote

Lensa; Minneapolis (MN); Remote; USD 286,000 - 398,000; Full time

Job summary

Join a forward-thinking organization as a Medical Director in Specialty Pharmacy, where your expertise will shape the future of healthcare. This role offers the flexibility to work remotely while you lead initiatives that enhance clinical outcomes and improve patient care. You will serve as a subject matter expert, collaborating with providers to ensure high-quality specialty pharmacy services. With a commitment to diversity and inclusion, this innovative firm provides a supportive environment where your contributions will make a significant impact. If you're passionate about advancing health equity and improving lives, this is the opportunity for you.

Benefits

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Qualifications

• 5+ years of clinical practice experience post residency required.
• Strong background in utilization management and quality management.

Responsibilities

• Provide utilization management services for specialty pharmacy clients.
• Engage with providers to discuss evidence-based guidelines.

Skills

Utilization management

Clinical practice

Interpersonal skills

Presentation skills

Disease management

Education

MD or DO with an active, unrestricted medical license

Board Certified in a Medical Specialty

Tools

MS Office

Job description

Medical Director - Specialty Pharmacy - Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Optum Medical Director Specialty Pharmacy 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 work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

1. Serve as a subject matter expert in specialty pharmacy drugs covered under the medical benefit to include sodium hyaluronate, inflammatory, intravenous immunoglobulin and multiple sclerosis drugs.
2. Perform utilization review determinations and support case and disease management teams to achieve optimal clinical outcomes.
3. Engage & collaborate with treating providers telephonically, discussing evidence-based guidelines, opportunities to close clinical quality/service gaps, and care plan changes that can impact health care expense.
4. Enhance clinical expertise of the specialty pharmacy team through education sessions with nursing teams.
5. 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.
6. Participate in rotational holiday and call coverage.

Required Qualifications:

1. MD or DO with an active, unrestricted medical license.
2. Board Certified in a Medical Specialty.
3. 5+ years of clinical practice experience post residency.
4. Demonstrated accomplishments in any of the following areas: Utilization management, Case management, Disease management, Quality management.
5. Computer skills to include MS Office and the ability to learn new technologies.

Preferred Qualifications:

1. Utilization management experience working in collaboration with a utilization management company, payor or hospital.
2. Experience working with clinical policy.
3. Effective presentation skills and interpersonal skills.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $286,104 to $397,743 annually. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

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.