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Careers at UnitedHealth Group


We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:




Approximate Salary:

Not Specified

Position Type:

Full Time

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Senior Manager of Pharmacy Audit - Irvine, CA

UHG - Irvine, California

Posted: 11/9/2018

We're changing the way health care works for the better. That means consulting with our members, partnering with our physicians, and delivering drugs in the most efficient and effective way. Join us and start doing your life's best work.(sm)


Primary Responsibilities:

  • Lead diverse team of investigators and analysts in pursuit of FWA identification
  • Responsible for administering audit plan across key clients
  • Drive resolution to key pharmacy audit escalations across business partners such as network compliance and relations, finance, and UHC SIU / PI
  • Collaborate on proactive solutions with key clients, client services, and legal team related to FWA matters
  • Serve as central point of contact and subject matter expert for FWA for key clients
  • Anticipate client's needs and proactively builds relationship through ongoing meetings, presentations, escalations, and resolution of issues
  • Design policy and procedures around new FWA initiatives
  • Direct responsibility for metrics, recoveries, and IOI generated under program for key clients
  • Assesses and interprets pharmacy audit requirements and needs of client / client account management
  • Collaborate with, and present to, senior business leaders to deliver highlights of emerging FWA trends
  • Adapts department plans and priorities to address business and operational challenges
  • Excellent verbal and written communication skills

Demonstrated Skills:

  • Highly flexible, open to change and new information
  • Demonstrated leadership of team and bench strength development
  • Manages ambiguity, adapting behavior and work methods to changing organization, adapting best practices in all processes
  • Establishes trust and credibility and follows through on commitments
  • Effective data analysis and interpretation skills
  • Ability to focus on key metrics and frame their overall impact on business objectives
  • Uses careful listening, tact, and candor in all communication
  • Demonstrated problem solving skills; ability to dig into the details
  • High employee engagement and manger index/values
  • Excellent presentation skills


Required Qualifications:

  • Bachelor’s Degree, or higher, required. Equivalent work experience will be considered
  • 3+ years of experience in Pharmacy or Healthcare industry, preferably PBM
  • 3+ years of relevant experience managing a team and/or managing a client
  • At a minimum, State Pharmacy Technician Licensure and National Certification required, or higher
  • Proficiency utilizing MS Office: Word, Excel, PowerPoint, Access and Outlook
  • Experience with data analysis and manipulation of data
  • Must be highly organized with effective and persuasive communication skills

Preferred Qualifications:

  • Experience managing a client
  • PBM experience


Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)




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.



Job Keywords: Pharmacy, Licensed, Pharmacy Technician, Pharm Tech, National Certification, Fraud, Waste, Abuse, FWA, Investigator, SIU, Auditor, Audit, Medical Records, Manager, Management, Supervisor, Supervisory, Irvine, CA, California

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