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Job Details
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
This position reports to the Director, Clinical Consulting Coding Team. The Business Analyst provides support to the Clinical Consulting Coding Team. Assistance to Clinical Pharmacists may include clinical coding reporting, POS clinical program analysis, clinical programs review, claim research, translating custom formulary rules to code, and other tasks related to clinical coding efforts both account specific or global projects.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
- Serve as Business Analyst on business segment for client implementations
- Provide guidance and mentorship to level I analysts, both new & experienced, to share knowledge and skills in order to prepare them to work autonomously in future custom implementations
- Work alongside clinical pharmacists to translate incumbent PBM data during implementation
- Serve as the point person to translate new client formulary files into workable/analyzable formats
- Analyze similarities and differences between Optum Utilization Management programs and client UM
- Perform label name analysis along with level of coding so formulary data can be populated on CBDT
- Assist in creating a client matrix which is used internally to ensure correct programs get attached per formulary design
- Design & build complementary custom test beds for more complex custom UM and other point of sale clinical programs
- Assist with comprehensive and parallel testing reviews
- Participate in client calls to address concerns during implementation
- Ability to work efficiently in multiple systems including RxClaim, RxBuilder, Zynchros, IFMS and other applicable systems
- Creates custom reports through reporting tools with forward-thinking objectives
- Ability to work closely with multiple departments to discuss issues and solutions, as well as partnering with teammates to share workloads and divide tasks as needed to meet time frames
- Displays an eagerness to learn and grow within the Clinical Coding Consulting Team
You'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:
- 2+ years of RxClaims processing/formulary PBM experience
- Experience understanding, generating, organizing, compiling and manipulating data with minimal oversight
- Experience presenting to cross functional teams and/or to external clients
- Experience collaborating with team members
- Experience managing project deliverables and deadlines
- Intermediate MS Excel experience with ability to manipulate large data sets using Excel functions (pivot tables, vlook up)
Preferred Qualifications:
- Pharmacy Technician certification and/or registered professional in healthcare
- SQL training/experience or certification
- 3+ years of RxClaim plan build/formulary experience
- Experience RxBuilder
- MS Excel macro training/experience
- MS Access
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At 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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
At UnitedHealth Group, we’re a health care and well-being company committed to helping people live healthier lives and helping make the health... Read more