Associate Director Prior Authorizations Operations Remote

UnitedHealth Group•Eden Prairie, MN

2h•$112,700 - $193,200•Remote

About The Position

The Associate Director, Prior Authorization Operations leads a high-volume pharmacy prior authorization operation, setting direction for a team of leaders and a workforce of more than 100 clinicians and technicians. The role owns operational, quality, compliance, and financial performance and drives innovation and process improvement across the end-to-end prior authorization process. Working with Clinical Services, Client Services, Compliance, and Technology, the Associate Director connects daily operations to enterprise strategy and enables technology solutions that improve the member, provider, and client experience. The position offers an opportunity to grow toward broader leadership roles at OptumRx. The role may be performed remotely from anywhere within the United States. It requires flexible working hours between 7:00 AM and 7:00 PM, including weekends as business needs require. Remote employees must adhere to UnitedHealth Group’s Telecommuter Policy.

Requirements

Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy, with an active, unrestricted pharmacist license.
At least 5 years of pharmacist experience, including at least 3 years in prior authorization or utilization management.
At least 3 years of people leadership experience, including leading teams through operational or process change.
In-depth clinical knowledge of disease states, pharmacotherapy, and current treatment guidelines, including specialty and high-cost therapies.
Ability to interpret complex clinical scenarios and apply medical necessity criteria, FDA labeling, and compendia to coverage decisions.
Proven record of delivering measurable improvements in turnaround time, quality, productivity, or cost in a regulated environment.
Demonstrated experience leading process improvement or technology-enabled initiatives from concept through measurable outcomes.
Solid executive communication skills, including ability to turn clinical, operational, and data insights into clear recommendations for leaders and clients.
Solid data fluency with Excel, PowerPoint, Word, and Outlook; working proficiency with Microsoft Copilot or other company-approved AI tools.
Ability to work flexible hours between 7:00 AM and 7:00 PM, including weekends as business needs require.

Nice To Haves

Lean, Six Sigma, Agile, or project management certification; MBA, MHA, or managed care residency.
At least 1 year of client-facing experience presenting performance results and improvement plans.
PBM or managed care experience operationalizing clinical guidelines, formulary, and benefit design across Medicare Part D, Commercial, and/or Medicaid.
Hands-on experience deploying workflow automation or AI solutions in a clinical or operational setting.
Financial acumen, including building business cases and quantifying ROI, cost-to-operate, and capacity impact.

Responsibilities

Lead 5 or more direct reports and more than 100 indirect pharmacists and technicians; coach, develop, and build a bench of future leaders.
Own end-to-end performance, including turnaround time, quality, productivity, service, and regulatory and contractual guarantees, using real-time inventory and queue management.
Partner with department leadership on volume forecasting, capacity and staffing plans, and budget management.
Drive innovation and continuous process improvement across the prior authorization process to improve outcomes.
Partner with Technology and Product teams to define requirements, pilot and scale solutions, and lead change management and adoption across teams.
Serve as the clinical and operational escalation point for complex cases; represent Prior Authorization Operations with Clinical Services, Client Services, Compliance, and in client meetings.
Maintain audit readiness and compliance with CMS, state, accreditation, and client requirements; monitor quality and safety trends and drive measurable action plans.
Build a culture of accountability, transparency, patient and workforce safety, well-being, and continuous improvement.