Role Description As a Medical Director, Utilization Management, you will report directly to the Chief Clinical Officer and support key C-suite clinical initiatives. This is a leadership role with responsibility for providing medical and strategic oversight of utilization management while leading and developing a clinical Utilization Management team. You will guide the evaluation of the clinical necessity and appropriateness of oncology treatments, ensuring cost-effective, evidence-based care without compromising patient outcomes, while partnering closely with executive, clinical, and operational leaders across the organization. - Conduct medical reviews and make independent clinical decisions of hematology and oncology treatment plans to determine medical necessity, appropriateness, and alignment with value-based clinical guidelines and evidence-based practices. - Review and assess the appropriateness of ongoing cancer treatment plans, ensuring that they align with evidence-based medicine and clinical best practices. - Provide clinical guidance and recommendations that balance quality, outcomes, and cost-effectiveness. - Liaise with providers, insurance companies, and patients to clarify and discuss treatment options and coverage. - Evaluate clinical and utilization data to identify trends, variations in care, and opportunities for improvement. - Partner with clinical and operational teams to support value-based care. - Ensure compliance with organizational policies, regulatory standards, and payer requirements in all clinical decisions. - Participate in the development and continuous improvement of utilization management protocols and criteria specific to oncology. Qualifications - Medical degree (MD or DO) - Board Certification in Oncology. - Minimum of 5 years of clinical experience in oncology. - 2+ years of Utilization Management experience. - Proven expertise in Utilization Management or experience with reviewing clinical appropriateness of treatment plans. - Strong understanding of oncology-specific treatment protocols, guidelines, and reimbursement policies. - Excellent analytical skills and the ability to evaluate complex clinical data. - Ability to work independently and make evidence-based decisions in a collaborative, multidisciplinary setting. - Excellent communication skills to engage effectively with healthcare providers, payers, and patients. Company Description Founded in 2007, The Oncology Institute (NASDAQ: TOI) is advancing oncology by delivering highly specialized, value-based cancer care in the community setting. TOI offers cutting-edge, evidence-based cancer care to a population of approximately 1.9 million patients, including clinical trials, transfusions, and other care delivery models traditionally associated with the most advanced care delivery organizations. With over 180 employed and affiliate clinicians and over 100 clinics and affiliate locations of care across five states and growing, TOI is changing oncology for the better.

Role Description The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support, and maintain clinical and operational processes related to benefit coverage determinations, quality improvement, and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on post-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services. The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member’s primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost effective quality medical care is provided to members. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations. - Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements. - 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. - Participate in daily clinical rounds as requested. - Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy. - Communicate and collaborate with other internal partners. Qualifications - M.D. or D.O. - Active unrestricted medical license and ability to obtain additional state medical licenses as needed. - Current board certification as a Surgeon through ABMS or AOA. - 5+ years of clinical practice experience after completing residency training. - Proven sound understanding of Evidence Based Medicine (EBM). - Demonstrated PC skills, specifically using MS Word, Outlook, and Excel. Requirements - Compact License. - Experience in utilization review. - Demonstrated data analysis and interpretation aptitude. - Proven innovative problem-solving skills. - Proven excellent presentation skills for both clinical and non-clinical audiences. - Demonstrated excellent oral, written, and interpersonal communication skills, facilitation skills. Benefits - Comprehensive benefits package. - Incentive and recognition programs. - Equity stock purchase. - 401k contribution (all benefits are subject to eligibility requirements). Company Description 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.

Role Description The Medical Science Liaison I (MSL), Specialties, serves as the scientific/clinical expert and ambassador for genomic testing to GeneDx’s clients. The MSL I, Specialties is a field-based position and will travel within the Mid-Atlantic US to educate medical professionals and provide clinical support to GeneDx’s sales team and clients. The MSL I, Specialties develops relationships with key opinion leaders in the regional clinical community and frequently gives scientific presentations at conferences and GeneDx-hosted events. The MSL I, Specialties also partners closely with regional sales leadership to direct field sales strategy and maximize sales force effectiveness. Job Responsibilities - Represent GeneDx as the genomic and clinical expert to clinicians, hospitals, and academic institutions, as well as regional professional organizations & patient advocacy groups. - Build relationships with regional key opinion leaders and key decision makers. - Deliver scientific/clinical presentations on genomics and genetic testing related to the GeneDx product portfolio. - Support genetics professionals and non-genetic professionals with clinical information and educational materials that promote access to genomic testing. - Support healthcare providers and administrators in implementing programs that operationalize pre-test counseling, test result interpretation, and test result-based clinical management. - Gather insights gained from clients, including regional needs and gaps in genomic services; share these insights with the appropriate stakeholders internally and champion action for priority items. - In partnership with Regional Sales Directors (RSDs) and Training & Sales Enablement, ensure Regional Account Executives (RAEs) have the product knowledge, as well as the sales & business skills, to maximize sales force effectiveness. - Spend time in the field with individual RAEs assessing needs, reviewing objectives, and developing action plans; identify opportunities for coaching & performance management and communicate these to the RSD for action. - In partnership with RSDs, direct execution of sales strategies and tactics, and implementation of sales and marketing plans. Qualifications - Master's Degree in Genetic Counseling. - 3+ years’ experience in a clinical or academic role or industry role as a genetic counselor. - <2 years' experience in an MSL or similar role in industry. - Excellent written and verbal communication skills. - Strong presentation and public speaking skills. - Ability to work independently and manage time effectively. - Willing to travel 60% of time within the assigned region. Certificates, Licenses, Registrations - None Work Environment This is a fully remote position. The employee will work from a home office or other suitable remote location with reliable high-speed internet access. Work is performed in a climate-controlled environment using standard office equipment including computer, phone, and video conferencing tools. Your standard work schedule and hours will be established in collaboration with your leader and may be adjusted to align with evolving business needs. Physical Demands - Sitting for extended periods (up to 8 hours per day). - Repetitive use of hands and fingers for typing and mouse operation. - Visual acuity for reading computer screens and documents. - Ability to communicate effectively via phone and video calls. - Occasional lifting of up to 10 pounds (office supplies, equipment). Acknowledgements The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions and perform any other related duties, as assigned by their supervisor. Pay Transparency, Budgeted Range $150,000 — $165,000 USD Benefits - Paid Time Off (PTO). - Health, Dental, Vision and Life insurance. - 401k Retirement Savings Plan. - Employee Stock Purchase Plan. - Employee Discounts. - Voluntary benefits. - Programs for parents and parents-to-be, including up to 22 weeks of fully paid parental leave (U.S.) and up to $25K annually for fertility, adoption, or surrogacy.

Title: Medical Director Oncology - Utilization Management - Remote anywhere in US Location: United States Requisition number: 2286240 Job category: Medical & Clinical Operations vertime status: Exempt Travel: No Job Description: 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 Medical Director Oncology will provide utilization review determinations and support case and disease management teams to achieve optimal clinical outcomes. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Perform utilization review determinations for oncology populations, and support case and disease management teams to achieve optimal clinical outcomes - Serve as a subject matter expert in evidence - based oncology guidelines, especially those produced by the National Comprehensive Cancer Network (NCCN), and help ensure all clinically relevant policies and processes are informed by the best available evidence - Engage and collaborate with treating providers telephonically; This will include discussion of evidence-based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expense - Enhance clinical expertise of the Oncology team through education sessions with nursing teams, and serving as a thought leader and point of contact for relevant medical societies and stakeholders - Evaluate clinical and other data (e.g., quality metrics, claims and health record data, utilization data) to identify opportunities for improvement of clinical care and processes - Collaborate with operational and business partners on enterprise-wide research and clinical and quality initiatives to enhance Optum impact in the oncology field 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: - MD or DO with an active, unrestricted medical license - Obtain additional licenses as needed - Current Board Certification in an ABMS or AOBMS specialty in Oncology - 5+ years of clinical practice experience (inclusive of Medical Oncology) - Experience working with NCCN guidelines - Demonstrated accomplishments in the areas of medical care delivery systems, utilization management, case management, disease management, quality management, product development, and/or peer review - Participate in rotational holiday and call coverage Preferred Qualification: - Experience in managed care and quality management - All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy The salary range for this role is $238,000 to $357,500 annually based on full-time employment. 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 education, work experience, certifications, etc. 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. 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.