Pharmacy Audit Analyst - Administrative - Partial Telecommute, Irvine CA

Company: UnitedHealth Group
Location: Phoenix
Posted on: May 28, 2023

Job Description:

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. -

If you are located in Irvine, CA, you will have the flexibility to work remotely*, as well as work in the office as you take on some tough challenges.

Primary Responsibilities: -

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• Manages group mailbox - Checks and replies to messages as needed. Forwards messages to managers or other teams as appropriate and saves & uploads documents received via email
  
• Manages failed fax attachments folder - Monitors the failed fax attachments folder. Copies all files into the archives folder, then checks each file, saves and uploads the documents as appropriate to clear the folder daily
  
• Manages group VM - Checks, transcribes and logs group voicemail messages daily
  
• Sends out notifications to the team to make follow up calls as needed
  
• Onsite mail - Goes onsite (Irvine Office) to manage physical mail. Saves and upload documents to corresponding audits. Logs and files documents for Iron Mountain storage
  
• BSL Tasks as needed
  
• Uses pertinent data and facts to identify and solve a range of problems within area of expertise
  
• Investigates non-standard requests and problems, with some assistance from others
  
• Works exclusively within a specific knowledge area (audit)
  
• Prioritizes and organizes own work to meet deadlines
  
• Provides explanations and information to others on topics within area of expertise
  
• Communicates with pharmacies for their own audits with the exception of escalations
  
  
  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: -
  
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  • High School Diploma / GED (or higher) -
    
  • Current and unrestricted Pharmacy Technician License for the state of residence
    
  • Must be currently certified by the PTCB (Pharmacy Technician Certification Board)
    
  • 3+ years of experience in a position processing/auditing pharmacy claims
    
  • 2+ years of experience working in pharmacy audit, PBM, healthcare investigations, or health insurance environment
    
  • 1+ years pharmacy benefits management audit experience
    
  • In - depth knowledge of pharmacy operations
    
  • Microsoft Office skills: (Word - creating and editing documents, Excel - creating and maintain spreadsheets)
    
    
    Preferred Qualifications:
    
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    • Bachelor's Degree (or higher)
      
    • Proficient in RxClaim and Online Reporting
      
    • An intermediate level of knowledge with Local, State & Federal laws and regulations pertaining to health insurance (Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy and/or commercial health insurance)
      
      
      Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges. -
      
      California Residents Only: The salary range for California residents is $46,700 to $91,300. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. -
      
      *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy -
      
      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. - -
      
      
      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: UnitedHealth Group, Phoenix , Pharmacy Audit Analyst - Administrative - Partial Telecommute, Irvine CA, Administration, Clerical , Phoenix, Arizona