Job: Senior Pharmacy Claims Business Process Analyst - Plano, TX; Denver, CO; Irvine, CA

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Jobing Description

Position Description:

Flexible, Friendly, Fast on your feet, That's a great start. Accurate, Accountable, Self Directed, These traits can take you places. Our claims operations are the focal point of handling information about services patients receive and the way those services get paid. It's complex, detailed work. It's fast paced challenge. It's a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment.

Primary Responsibilities:

• Perform capacity planning and reporting


• Claims related and business system analysis


• Responsible for all aspects of quality assurance


• Create and edit requirements, specifications, cost benefit analysis and recommendations to proposed solutions


• Facilitate development of process documentation


• Generally work is self-directed and not prescribed.


• Works with less structured, more complex issues.


• Serves as a resource to others


• Assesses and interprets customer needs and requirements


• Direct supervision of staff


• Identifies solutions to non-standard requests and problems.


• Solves moderately complex problems and/or conducts moderately complex analyses.


• Works with minimal guidance; seeks guidance on only the most complex tasks


• Translates concepts into practice


• Provides explanations and information to others on difficult issues


• Coaches, provides feedback, and guides others


• Acts as a resource for others with less experience.

OptumRx is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable health care solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance.

OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do. In the largest and most personal sense, your impact can be greater than even you thought at OptumRx.

Skills / Requirements

Requirements:

• Bachelor's Degree OR a high school diploma/GED with 5+ years of related Pharmacy experience required


• 2+ years of experience analyzing and solving customer problems in a Pharmacy Benefit Management Environment required


• Advanced level of proficiency with MS Excel required


• RxClaims experience required


• The ability to multitask required


• Ability to understand multiple products within multiple levels of pharmacy benefits required


• Project Management experience preferred

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V



UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.