[Hiring] Medical Director, Hematology/Oncology @UnitedHealth Group

Role Description

Transplant Resource Solutions is seeking a board-certified Medical Director with expertise in transplantation and cellular therapies. In this individual contributor role, the Medical Director serves as a clinical subject matter expert, providing physician support to Enterprise Clinical Services and collaborating with internal and external stakeholders to support evidence-based clinical decision-making.

This physician applies specialized transplant knowledge to:

• Utilization management activities
• Benefit coverage determinations
• Quality programs
• Centers of Excellence evaluations

The Medical Director partners with clinical and operational teams to:

• Assess complex transplant-related issues
• Interpret evolving clinical evidence
• Support consistent, high-quality coverage decisions for members

The role requires extensive collaboration with:

• Network and non-network physicians
• Provider organizations
• Client stakeholders

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

Primary Responsibilities:

• Serve as a clinical subject matter expert for solid organ transplantation, blood and marrow transplantation (BMT), stem cell transplantation, CAR-T therapies, and emerging cellular therapies
• Apply clinical expertise to support benefit coverage determinations, medical necessity reviews, and utilization management activities
• Participate in the evaluation and enhancement of transplant and cellular therapy clinical guidelines and Centers of Excellence (COE) criteria
• Review and interpret emerging clinical evidence, industry trends, and regulatory developments related to transplantation, cellular therapies, gene therapies, and hematologic malignancies
• Collaborate with internal and external stakeholders to assess quality outcomes, accreditation standards, clinical performance measures, and COE qualifications
• Provide clinical consultation and expertise in support of new business opportunities, client renewals, and program development activities
• Participate in client-facing discussions, clinical consultations, and program reviews related to transplant and cellular therapy services
• Build collaborative relationships with client medical directors, physician leaders, provider organizations, and transplant centers
• Support provider qualification, designation, and performance review activities for transplant and cellular therapy Centers of Excellence
• Analyze clinical and operational data to identify trends, opportunities, and areas for improvement in quality, utilization, and member outcomes
• Support peer-to-peer discussions and clinical consultations regarding transplant-related coverage determinations and complex clinical cases
• Represent the organization at professional meetings, conferences, and industry organizations, including NMDP, UNOS, SRTR, and CIBMTR

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
• Specialized expertise in Hematology/Oncology with experience in Blood and Marrow Transplantation (BMT), stem cell transplantation, CAR-T therapy, immune effector cell therapies, or related cellular therapy programs
• 5+ years of clinical experience in transplantation and/or cellular therapy, including transplant patient care, transplant program operations, blood and marrow transplantation (BMT), stem cell transplantation, CAR-T therapy, transplant-related medical management, or utilization management
• Experience evaluating clinical literature, evidence-based guidelines, quality metrics, and healthcare outcomes
• Experience utilizing clinical and operational data to support quality improvement and performance optimization initiatives
• Knowledge of NCQA, URAC, CMS, and applicable state and federal regulatory requirements
• Demonstrated ability to collaborate effectively with multidisciplinary teams and influence stakeholders through clinical expertise and consultation
• Proven solid written and verbal communication skills with the ability to explain complex clinical concepts to diverse stakeholders

Requirements

• Experience supporting clinical oversight, quality management, utilization management, case review, or program development activities within transplant or cellular therapy programs
• Experience serving as a physician advisor, consultant, or clinical subject matter expert for Blood and Marrow Transplantation (BMT), cellular therapy, immune effector cell therapy, or transplant Centers of Excellence programs
• Experience working within large, matrixed healthcare organizations
• Experience integrating clinical and financial information to support quality, utilization, and cost-effectiveness initiatives
• Familiarity with quality and outcomes reporting through organizations such as UNOS, SRTR, CIBMTR, FACT, or NMDP
• Advanced proficiency with Microsoft Office applications, including Word, Excel, and PowerPoint
• Proven solid analytical, organizational, and project coordination skills
• Demonstrated success supporting improvements in healthcare quality, operational performance, and patient outcomes

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)