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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.

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

Working Eastern Time Zone business hours is required.

Primary Responsibilities:

• Clinical Excellence - National Medical Director will be a clinical thought leader who develops clinical value proposition focused on quality and partners with health plan leaders to promote evidence-based medical care that is efficient, effective, and satisfying for members and providers for all Medicaid clients for OptumRx

• Relationship Equity and State Compliance - maintains a solid working knowledge of all government mandates and provisions for the local markets, as well as working across the enterprise to implement and maintain compliance clinical programs and procedures

• Growth - delivers the clinical value proposition focused on quality, affordability, and service, in support of growth activities. The National Medical Director reviews and edits communications materials as required and represents the voice of the market-based customer in program design. National Medical Director contributes to any RFP/re-procurement activity as appropriate

• Human Capital - the National Medical Director embraces, supports, and helps to continuously improve the company’s positive and inclusive workplace

• Travel and participate in P&T (Committee Pharmacy & Therapeutics Committee) committee meetings and DUR (Drug Utilization Review) board meetings in-person or virtually as needed and provide clinical expertise and present materials

• Work collaboratively with pharmacists to develop and review new drug reviews and update giving clinical oversight and guidance

• Provide expertise to analyze the clinical and financial implications of changes in Preferred Drug List discussions

• Travel and provide SSDC (Sovereign State Drug Consortium) support including clinical insights and presentations

• Oversight of clinical prior authorization activities for pharmacy benefit services. Engage with requesting providers as needed in peer-to-peer discussions

• Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews

• Highly effective communicator who will collaborate with external and internal partners including executives supporting the Medicaid plans

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:

• Successful completion of a medical residency

• Active and unrestricted M.D or D.O. license to practice medicine

• Board certification in an ABMS specialty

• 5+ years of clinical practice experience after completing residency training

• Proven experience in working within a PBM or Health Plan with exposure to pharmacy benefit services management

• Proven experience with analysis of Evidence Based Medicine (EBM) research related data analysis

• Proven experience in formal presentation for both clinical and non-clinical audiences

• Proven solid PC skills, specifically using MS Word, Outlook, Power Point, and Excel

• Willing or ability to travel to support in person meetings for 50% of time

Preferred Qualifications:

• Hematology Oncology, Psychiatry, or Infectious Disease specialist

• Experience in Medicaid line of business

• Participation in clinical practice

• Experience with P&T (Committee Pharmacy & Therapeutics Committee) committee meetings and DUR (Drug Utilization Review) board meetings

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

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $383,977 to $561,553 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). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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.

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.