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, and Centers of Excellence evaluations. The Medical Director partners with clinical and operational teams to assess complex transplant-related issues, interpret evolving clinical evidence, and support consistent, high-quality coverage decisions for members. The role requires extensive collaboration with network and non-network physicians, provider organizations, and client stakeholders while serving as a trusted clinical resource across transplant and cellular therapy programs.
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
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
- 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
Preferred Qualifications:- 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
*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 $248,500 - $373,000 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.
