Pharmacy Operations Analyst - Business Analyst - Remote

Company: UnitedHealth Group
Location: Eden Prairie
Posted on: January 26, 2023

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