Remote Utilization Review Jobs in Farmington, MN

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.    

Transplant Resource Solutions is seeking a board-certified Senior Medical Director with transplant expertise to provide clinical leadership, support business growth, strengthen client and provider relationships, and advance quality across transplant programs. This physician leader will partner with clinical experts, clients, providers, and internal stakeholders to guide clinical strategy, evaluate Centers of Excellence, and drive evidence-based improvements that enhance outcomes and program performance.

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

Primary Responsibilities:

• Provide clinical leadership and strategic guidance for transplant programs and initiatives
• Lead expert panel discussions and support the development of clinical guidelines and Centers of Excellence (COE) standards
• Serve as a transplant subject matter expert and educate internal teams, clients, and stakeholders on industry trends and best practices
• Support new business opportunities, client renewals, and pricing strategy through clinical consultation
• Lead clinical discussions, case reviews, and performance reviews with clients
• Build relationships with client medical directors, physician leaders, and provider organizations
• Participate in provider COE qualification and performance review activities
• Analyze clinical and operational data to identify trends and improvement opportunities
• Represent the organization at industry conferences and professional committees, including NMDP, UNOS, SRTR, and CIBMTR

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:

• Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree
• Current, unrestricted physician license
• Board certification through an ABMS- or AOA-recognized specialty board
• 5 years of clinical experience in transplantation, including transplant patient care, transplant program leadership, transplant-related medical management, or utilization management
• 5 years of experience in a physician leadership role
• Experience analyzing clinical and operational data to improve quality, outcomes, and performance
• Knowledge of NCQA, URAC, CMS, and applicable state and federal regulatory requirements
• Demonstrated ability to lead cross-functional teams, influence stakeholders, and drive strategic initiatives

• Proven success leading process improvement, organizational change, and innovation initiatives

Preferred Qualifications:

• Board certification, fellowship training, or clinical leadership experience in a transplant-related specialty such as Nephrology, Transplant Hepatology, Hematology/Oncology, Cardiology, Pulmonary Medicine, or Transplant Surgery
• Experience working within large, matrixed healthcare organizations
• Advanced proficiency with Microsoft Office applications, including Word, Excel, and PowerPoint
• Proven expertise integrating clinical and financial data to drive quality, utilization, and cost improvement initiatives
• Proven solid program and project management skills
• Demonstrated success improving healthcare quality, operational performance, and patient outcomes
• Proven significant clinical expertise in transplantation, including experience within solid organ transplantation and/or blood and marrow transplantation programs

*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 $292,300 - $438,500 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.