Energize your career with one of Healthcare’s fastest growing companies.
You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.
This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.
Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.
If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.
Positions in this function include those responsible for providing process and operational support to the functions within Business Operations Family. Positions in this function may also be responsible for quality reporting, analysis and audits, and for developing plans and programs to support continuous quality improvement using applicable tools.
- Gather information (e.g., emails; phone calls) from vendors and business partners regarding requests for services or key issues to be addressed (e.g., field phone calls and emails)
- Create service tickets to be escalated to appropriate partners (e.g., business areas; senior leadership)
- Remain aware of, identify, and / or communicate performance discrepancies that may present opportunities for improvement or problems to be addressed
- Maintain relevant operations information (e.g., SOPs; policies and procedures; process changes; problem resolution steps) within appropriate tracking and documentation systems
- Monitor and / or report performance against contract service deliverables with internal and / or external partners
- Ensure reports and operational tasks are completed within stated deadlines and follow set policies and procedures
- High School Diploma / GED (or higher)
- Understanding of relevant federal and state regulatory guidelines (e.g., CMS)
- Understanding of relevant software applications (e.g., SharePoint- ability to use applications and create sites / MS Office Excel- ability to create spreadsheets, sort and filter data/ Salesforce- the ability to maneuver in this application and the ability to search and share data)
- Ability to work flexible schedule
- Bachelor's Degree (or higher)
- Pharmacy Tech License
- Pharmacy Claims experience
- Knowledge of the Pega PAS
- Knowledge of Center for Medicare Services (CMS) Regulations
OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do.
If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable healthcare solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance. Join us and start doing your life’s best work.
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: Pharmacy Claims, Pharmacy Help Desk, Business Operations Specialist, Center for Medicare Services (CMS) Regulations