Eligibility Analyst – National Remote

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.

 

As an Associate Business Analyst you will work on a wide range of activities related to department including requirement analysis, implementations and development of action plans. Works with clients and internal work teams to ensure successful implementation and project work. Develops business requirements for Eligibility within assigned projects and follows them through to production. Troubleshoots and works with clients and/or IT to resolve issues and/or interpret perceived issues.

 

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

 

Primary Responsibilities:

• Serving as a liaison between clients and OptumRx to ensure eligibility requirements for all pharmacy eligibility setups are accurate, complete, and in accordance with designated plan design
• Role requires a strong external client facing ability and demonstrated experienced presentation skills to effectively communicate business requirements, analyze complex data, and drive strategic initiatives. Ideal candidate will also collaborate with both internal and external clients to ensure seamless implementations
• Maintaining, loading, and troubleshooting standard to moderately complex client eligibility files by researching and resolving discrepancies with client data to ensure timely and accurate updates to the online claims system
• Develops, formats, analyzes, and maintains internal and client eligibility reports. Ensures all fields within the client files are accurate and in accordance with National Council of Prescription Drug Program (NCPDP) standards
• This role involves managing external client relationships, delivering presentations, and providing exceptional service to ensure client satisfaction

 

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:

• PBM, Health plan, healthcare or clinic operations experience
• 1+ years of experience working directly with external and internal clients and must also possess solid proven presentation skills
• Some proficiency with Microsoft Excel, Word and Access
• Demonstrated ability to interact one-on-one and consult with all levels of management
• Demonstrated to be a self-starter with excellent communication, writing skills, time/project management, problem solving, organizational and solid analytical skills with the ability to review, identify and resolve discrepancies

 

Preferred Qualifications:

• Project Management experience
• RxClaim working knowledge
• Experience with SQL or other data analyzing tool 

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

 

The hourly range for this role is $23.70 to $46.35 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

 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.  

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