Sr Research Analyst - Telecommute

UnitedHealth Group

Date: Sep 23, 2022
City: Irvine, CA
Salary: $54,400 - $97,000 / year
Contract type: Full time
UnitedHealth Group
Optum is a company that\'s on the rise. We\'re expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn\'t about another gadget, it\'s about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life\'s best work.(sm)

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

Primary Responsibilities:
  • Uses pertinent data and facts to identify and solve a range of problems within area of expertise
  • Investigates non-standard requests and problems
  • Works exclusively within a specific knowledge area
  • Prioritizes and organizes own work to meet deadlines
  • Provides explanations and information to others on topics within area of expertise
  • Reviews and assesses quality and accuracy of audit conducted by Pharmacy Analysts. (QC)
  • QBR (Patricia), Quarterly CMS Claim Count (Dan M.) etc.
  • FAFR Amendment QC & Management
  • Leads special projects as assigned
  • Trains and develops Pharmacy Analysts and new hires
  • Provides ideas and recommendations on process improvements, team building, etc.
  • Develops and maintains team Job Aids
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 / GED (or higher)
  • Current and unrestricted Pharmacy Technician License for the state of residence
  • Currently certified by the PTCB (Pharmacy Technician Certification Board)
  • 4+ years of experience working in pharmacy audit, PBM, healthcare investigations, or health insurance environment
  • 4+ years of experience in a position processing/auditing pharmacy claim
  • 2+ 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)
  • Ability to work Monday through Friday 6am to 3pm, 7am to 4pm or 8am to 5pm PST
Preferred Qualifications:
  • 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)
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with OptumRx. We\'re one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here you’ll fill far more than prescriptions. As a member of one of our pharmacy teams, you’re empowered to be your best and do whatever it takes to help each customer. You\'ll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There\'s no better place to help people live healthier lives while doing your life\'s best work.(sm)

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $54,400 to $97,000. The salary range for Connecticut / Nevada residents is $60,000 to $106,700. 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 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.

How to apply

To apply for this job you need to authorize on our website. If you don't have an account yet, please register.

Post a resume