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.(sm)

You know the phrase “what’s in it for me”?  Here’s how it all adds up. Join our growing, global Fortune 7 company and you’ll be challenged and supported in equal measure. You’ll find greater purpose and impact. You’ll learn at an amazing pace and you’ll be helping to improve the lives of millions. Ready? In this specialist role, you’ll bring a strong customer service focus to the installation and administration of pharmacy contracts within various OptumRx systems. You’ll find the impact you want and the training, resources, backing and opportunities that you’d expect from an industry leader.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Assist with setting up pharmacy network structure in RxClaim
• Audit contract loads for adherence to quality measurers and reporting standards
• Create documentation for standard operating procedures (SOP)
• Make decisions guided by policies, procedures, and business plan
• Provide Client support on pharmacy claim investigations
• Audit work of others to identify and process / coordinate correction of loading errors
• Recommend methods to improve processes used by department
• Serve as a resource to others, including training of new employees                          

In addition to a fast pace and aggressive objectives, your role will be a challenge because you're working with intake forms and figuring out proper contractual loading. Knowledge of credentialing providers, provider relations, pharmacy benefit management (PBM) or quality management will go a long way in helping you succeed.

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:

• High school diploma or GED
• 3+ years of work experience in managed care or PBM experience (experience can include credentialing providers, provider relations, provider administration) 
• Demonstrated prioritization / organizational skills and attention to detail
• Demonstrated interpersonal and communication skills including telephone / email etiquette
• Basic level of proficiency with RxClaim, MS Excel and MS Word
• You will be required to adhere to UnitedHealth Group’s US Telecommuting Policy
• If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained

Preferred Qualifications:                

• Undergraduate degree
• Certified Pharmacy Tech (CPhT)
• Medicare Part D experience
• 1+ years of experience working with RxClaim
• Claims processing experience
• Plan Finder 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)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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: healthcare, health care, pharmacy benefit manager, pharmacy, PBM, network management, provider administration, Medicare Part D, RxClaim, OptumRx, Schaumburg, Illinois, IL, Irvine, California, CA