If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.

Optum has successfully leveraged healthcare data to bring together a more complete view of health, provide more personalized insights to inform healthcare decisions, to support our customers by providing affordable choices, and drive better options for healthcare that help individuals live a healthy life. In service to this mission, the Optum Genomics team is committed to sourcing high-quality genomics data to inform more complete view of health, to provide more contextualized data to drive desired health behaviors, to help route our customers to the most effective and affordable choices, and to facilitate the evidence needed to get impactful genomics products into the clinic quickly and responsibly.

The Molecular Pathologist role will be a key contributor on the Optum Genomics team and will support the definition and build out of capabilities to evaluate the analytical validity, clinical validity, and clinical utility of molecular diagnostics tests. The individual in this role will support multiple products in the Optum Genomics portfolio from both an internal development and external client-facing perspective.

Primary Responsibilities:

• Provide consulting / advisory services for Care Delivery Organizations (CDOs)
• Case review of molecular diagnostics utilization management - (UM) test requests
• Provide recommendation based on medical necessity for clinical scenarios and coverage determinations
• Collaborate with key UM staff and providers to ensure the appropriate test utilization
• Train staff on background details, clinical scenario(s), coverage criteria, required documentation, and other protocols for relevant genetic tests
• Provide expertise in client-facing discussions regarding Analytical Validity (AV), Clinical Validity (CV), and Clinical Utility (CU)
• Working with and defining tests with intended uses that could potentially be financially beneficial to payers
• Support product team for defining business rules for Prior Authorization /Utilization Management /Payment Integrity capabilities
• Internally supporting R&D to design and execute clinical evidence studies
• Accompany external clients to meet with payers, professional societies, and key opinion leaders regarding molecular diagnostic evidence generation
• Interface with key stakeholders to optimize for standardization and evidence sharing
• Provide medical diligence assessments for potential investments in precision medicine companies or products
• Work with internal medical leadership and statisticians to develop position statements, dossiers, and templates for rationalized evidence generation
• Partners with the Product team(s) to commercialize new genomics capabilities across businesses, in Client Support and Business Development

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 Pathologist with 10+ years clinical experience
• Experience with coding, coverage and reimbursement policies for molecular diagnostics
• Familiarity with the current and proposed regulation of laboratory developed tests (LDTs)
• Solid understanding of the principles of test design and validation
• Demonstrated ability to work in a fast-paced environment on multiple projects with tight deadlines
• Proven organizational skills with ability to be flexible and work with ambiguity

Preferred Qualifications:

• 5+ years industry experience
• Participation in relevant professional societies.
• Solid background in molecular oncology
• Exceptional ability to drive results through solid collaborating and influencing skills across all business segments and geographies
• Solid communication skills

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

Colorado Residents Only: The salary range for Colorado residents is $348,100 to $433,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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.

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