Remote Optum Utilization Review Jobs in Minnesota

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
The Director of Specialty Strategy is responsible for developing and executing the specialty pharmacy strategic plan for HealthTrust, ensuring alignment with client objectives, market trends, and enterprise priorities. Serving as the primary strategic advisor and subject matter expert for specialty pharmacy solutions, this role acts as the principal interface between HealthTrust, Optum Specialty and Optum Rx stakeholders.
The Director is accountable for translating client needs into actionable product, clinical, operational, and service strategies, bringing recommendations and market insights on behalf of the client to internal product and leadership teams. This position oversees the portfolio of specialty pharmacy products, programs, and services delivered to HealthTrust, ensuring solutions drive clinical excellence, optimize financial performance, enhance member and provider experience, and achieve client program objectives.
Working across product, clinical, operations, contracting, analytics, and account management teams, the Director provides strategic leadership, drives innovation, influences roadmap development, and ensures effective execution of specialty initiatives. The role requires a deep understanding of specialty pharmacy, emerging therapies, market dynamics, and client business needs, coupled with the ability to build trusted executive relationships and lead complex, cross-functional initiatives.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:

• Develop and execute a multi-year specialty pharmacy strategic plan for HealthTrust that supports client goals and business growth objectives
• Serve as the primary specialty pharmacy subject matter expert and strategic advisor to HealthTrust leadership and stakeholders
• Act as the principal liaison between HealthTrust, Optum Specialty, and internal Optum Rx product, clinical, operational, and executive teams
• Identify, assess, and recommend specialty pharmacy solutions, programs, and innovations that improve clinical outcomes, member experience, and total cost of care
• Advocate for client priorities by bringing strategic recommendations, market intelligence, and emerging opportunities to product and business leaders
• Influence specialty product strategy and roadmap development based on HealthTrust's evolving needs and competitive market dynamics
• Oversee performance and delivery of all specialty pharmacy services and programs supporting HealthTrust
• Monitor specialty pharmacy trends, pipeline therapies, biosimilars, gene therapies, and regulatory developments to identify opportunities and risks
• Lead executive-level discussions, business reviews, strategic planning sessions, and client presentations
• Collaborate with account management, analytics, clinical, operations, and contracting teams to ensure successful implementation and execution of specialty initiatives
• Establish and monitor key performance metrics to evaluate specialty program effectiveness and achievement of client objectives
• Drive continuous improvement efforts and strategic initiatives that enhance value, differentiate offerings, and strengthen the HealthTrust partnership

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:

• 5+ years of progressive experience within the healthcare, pharmacy benefit management (PBM), specialty pharmacy, managed care, or healthcare consulting industries
• 5+ years of experience developing and driving strategic initiatives, business plans, and client-focused solutions
• Demonstrated expertise in specialty pharmacy products, programs, clinical management strategies, and market trends
• Proven experience serving as a strategic advisor to executive stakeholders and large healthcare clients
• Solid understanding of specialty drug management, utilization trends, manufacturer strategies, reimbursement models, and emerging therapies
• Experience leading complex, cross-functional initiatives and influencing outcomes across product, clinical, operations, contracting, and account management teams
• Exceptional executive communication, presentation, relationship management, and negotiation skills
• Solid analytical and financial acumen with the ability to translate data into actionable business recommendations

Preferred Qualifications:

• Experience supporting large employer, health system, GPO, or national healthcare client relationships
• Knowledge of biosimilars, gene therapies, rare disease management, and value-based specialty care models
• Experience presenting strategy, performance, and recommendations to executive leadership and client stakeholders
• Experience working in highly matrixed organizations and managing multiple strategic priorities simultaneously

Key Competencies:

• Strategic Planning and Execution
• Specialty Pharmacy Expertise
• PBM Industry Knowledge
• Client Relationship Management
• Executive Influence and Leadership
• Product Strategy and Innovation
• Business and Financial Acumen
• Market Intelligence and Competitive Analysis
• Cross-Functional Collaboration
• Consultative Problem Solving
• Change Leadership
• Results Orientation

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
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 $112,700 to $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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.
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.
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.