Eligibility Business Analyst

This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. For all hires in Minneapolis, Virginia, Maryland, or Washington, D.C. area, you will be required to work in the office for a minimum of four (4) days per week. 

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 Eligibility Business Analyst you will work on a wide range of activities related to department including strategic planning, 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.

This position is full time (40 hours / week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm CST. It may be necessary, given the business need, to work occasional overtime and during peak season during 4th quarter of the year. 

This will be paid on-the-job training. The hours of the training will be based on schedule or will be discussed on your first day of employment.  

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 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:

• High School Diploma / GED
• Must be 18 years of age OR older
• 1+ years of experience working directly with external and internal clients
• Must possess presentation skills
• PBM, Health plan, healthcare OR clinic operations experience
• Intermediate level of proficiency with Microsoft Excel, Microsoft Word, and Microsoft Access
• Ability to interact one-on-one and consult with all levels of management
• Independent worker with communication, writing, time / project management, problem solving, organizational, and analytical skills with the ability to review, identify, and resolve discrepancies 
• Ability to work full time (40 hours / week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm CST. It may be necessary, given the business need, to work occasional overtime and during peak season during 4th quarter of the year.

Preferred Qualifications:

• Project Management experience
• RxClaim working knowledge given
• Experience with SQL OR other data analyzing tool
• Ability to navigate and analyze large data files

Telecommuting Requirements:

• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

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

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $23.89 - $42.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.