UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.
Description
UnitedHealth Group is working to create the health care system of tomorrow.
Already Fortune 25, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.
Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.
Position Description:
Positions in this function oversees the operational implementation and ongoing operational maintenance of UHPS clinical programs and associated systems and processes that are implemented and managed by third party pharmacy benefit administrator (PBA). These programs are implemented to support pharmacy benefit administration strategies that ensure appropriate utilization of specified programs and appropriate claim adjudication.
Primary Responsibilities:
- Creates and manages processes that provide line of sight into how clinical programs and rules are operationalized within PBA and develops and implements strategies to improve the agility and accuracy of program/rule implementation.
- Works and interfaces with other UHPS Operations personnel to ensure clinical programs/rules are implemented consistent with overall UHPS PDL strategies and timelines.
Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.
Qualifications
Qualifications:
- Undergraduate degree or equivalent business analyst experience is required.
- Health Care Operations experience is required.
- Intermediate MS/Office (Word, Excel & Outlook) is preferred.
- Business Analyst or System Analyst background is highly preferred.
- Experience as a Pharmacy Technician is preferred.
- Pharmacy Benefit Management (PBM) experience strongly preferred.
- PBM Claims experience preferred.
- Experience creating, implementing and maintaining logistical process for claims is a plus.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
