Pharmacy Operations Analyst - Business Analyst - Remote
Company: UnitedHealth Group
Location: Eden Prairie
Posted on: January 26, 2023
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Job Description:
Combine two of the fastest-growing fields on the planet with a
culture of performance, collaboration and opportunity and this is
what you get. Leading edge technology in an industry that's
improving the lives of millions. Here, innovation isn't about
another gadget, it's about making health care data available
wherever and whenever people need it, safely and reliably. There's
no room for error. Join us and start doing your life's best
work.(sm)We're looking for an operator who sees data as a language,
has a relentless drive for quality, and is growth minded.The
Pharmacy Operations Analyst partners with the Pharmacy Account
Manager (PAM), clinical teams, and pharmacy benefit manager (PBM)
to interpret and execute pharmacy benefit design changes and
implementations.The Pharmacy Operations Analyst also supports the
Medicaid formulary by investigating, reviewing, and analyzing
claims, creating formulary documentation, and maintaining formulary
coding files.As a key link in the formulary administration process,
you must maintain a high degree of attention to detail while
remaining flexible in an ambiguous atmosphere.The ideal candidate
would promote Our United Culture by acting with integrity and
compassion, while fostering relationships and innovation, and of
course - by performing!This position is full-time (40 hours/week)
Monday - Friday.Employees are required to work our normal business
hours of 8:00am - 5:00pm.You'll enjoy the flexibility to work
remotely * from anywhere within the U.S. as you take on some tough
challenges. Primary Responsibilities:Translate strategy and intent
into technical coding documentsPerform routine and moderately
complex claim, plan build, and implementation analysisWork
collaboratively with cross-organizational teams (PAM, PBM,
clinical) - build positive relationships, participate in calls and
projects, and ensure on-time quality resultsLead complex project
and issue resolution in assigned market(s)Audit processes by
analyzing and interpreting data to identify differences,
discrepancies, and opportunitiesProvide explanations and
interpretations within area of expertise at the manager/director
levelLeverage data and facts to identify and solve a range of
problems within area of expertise Other duties as assigned to
include project supportYou'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:3+ years of pharmacy, pharmacy benefit,
and/or PBM experience3+ years of experience performing significant
data analysis in a healthcare/corporate setting2+ years of
experience with documenting processes and practices while
effectively prioritizing tasks, priorities, projects, and
deadlinesAdvanced level of knowledge and experience with RxClaim
(AS400) - must be able to translate data, strategy, and intent into
coding documentsAdvanced proficiency with Microsoft Excel (has
skills to perform VLOOKUP, SUM, COUNTIF, Pivot Tables,
etc.)Excellent written and oral communication skills with a
demonstrated ability to collaborate and communicate up to and
through Director level stakeholdersPreferred
Qualifications:Bachelor's degree in Business, Health
Administration, or related field and/or equivalent work
experienceCertified Pharmacy TechnicianClaims auditing or SME
experience and/or controls and performance monitoring
experienceExperience with process automation (SAS, SQL, or Excel
Macros)Understand the end-to-end environment of pharmacy claims
processes including point of sale adjudication, accumulation
processes, and claim reprocessingCareers with OptumRx. We're one of
the largest and most innovative pharmacy benefits managers in the
US, serving more than 12 million people nationwide. Here you'll
fill far more than prescriptions. As a member of one of our
pharmacy teams, you're empowered to be your best and do whatever it
takes to help each customer. You'll find unrivaled support and
training as well as a wealth of growth and development
opportunities driven by your performance and limited only by your
imagination. Join us. There's no better place to help people live
healthier lives while doing your life's best work.(sm)California,
Colorado, Connecticut, Nevada, New York City, or Washington
Residents Only: The hourly range for California, Colorado,
Connecticut, Nevada, New York City, or Washington residents is
$27.07 to $53.08. 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.*All employees
working remotely will be required to adhere to UnitedHealth Group's
Telecommuter PolicyAt 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.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.
Keywords: UnitedHealth Group, Eden Prairie , Pharmacy Operations Analyst - Business Analyst - Remote, Professions , Eden Prairie, Minnesota
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