Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)
Hours: 8-hour shift, Monday - Friday, during standard business hours
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Analyze book of business to determine patterns/trends of fraud, waste, abuse and error
Amends audit reports and determines overpayments specific to fraud, waste, abuse and errors
Collaborates with Claims Administration and/or management in the reverse and re - billing of overpaid claims specific to fraud, waste and abuse trends
Collaborate on proactive solutions with client, client services, and legal team related to fraud, waste and abuse matters
Present ideas and best practices to management to address business and operational process improvements
Coordinating audit referrals to various audit types
Coordination of timely closure of audits
Reviews and analyzes claims data, applying knowledge of pharmacy policy / practice and data mining techniques to determine details of overpayment billing activity while assisting with oversight of contracted program
Monitors and reports accordingly any compliance issues with regulatory requirement
Identifies and documents fraudulent or erroneous activities determined as a result of a desktop or an on - site audit
Prioritizes and organizes own work to meet agreed upon deadlines
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.
High School Diploma or GED
Current and unrestricted Pharmacy Technician license in the State of residence
National Pharmacy Technician Certification
3+ years of experience as a Pharmacy Technician
Intermediate proficiency with computer skills including Microsoft Outlook, Word, and Excel
5+ years of experience as a Pharmacy Technician
1+ years of experience in Pharmacy Audit
RxClaims or other pharmacy claims system experience
Retail Pharmacy experience
Long Term Care Pharmacy experience
Specialty Pharmacy experience
To protect the health and safety of our workforce, patients, and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles 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)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $45,100 to $80,200. The salary range for Connecticut / Nevada residents is $49,800 to $88,200. 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
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 lower 48 law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: Pharmacy Audit Analyst, Pharmacy Benefits Management, PTCB, Pharmacy Technician, Pharmacy Audit, Investigations, Pharmacy Claims, Telecommute, WFH, Work From Home, WAH, Work At Home, #RPO, #Green