[Hiring] Associate Benefit Analyst @UnitedHealth Group

Role Description

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.

The Benefit Operations Management (BOM) team is responsible for error free point of sale pharmacy script adjudication. An Associate Benefit Analyst will play a critical role by partnering with clients and Optum Rx stakeholders to assess, define, and perform pharmacy benefit implementations and ongoing maintenance within the RxCLAIM™ adjudication system. This work includes:

• New plan builds
• Updates to existing plans
• Copy/change requests
• Global updates

It’s a fast paced, high-volume environment that requires you to work independently while maintaining a strong focus on company policies and guidelines. Accuracy is vitally important and subject to auditing internally and externally to ensure our system is correctly configured and aligned with client defined benefit requirements and performance guarantees.

Assets needed for an Associate Benefit Analyst include:

• A high degree of personal accountability
• Detail oriented
• Ability to analyze and solve complex problems
• Excellent conflict resolution skills
• Timely strong written and verbal skills
• Superior organizational skills
• Innovative thinking
• Ability to work on multiple projects simultaneously and prioritize accordingly

This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00 am - 5:00 pm local time. It may be necessary, given the business need, to work occasional overtime or weekends.

We offer weeks of on-the-job training and the hours during training will be 8:00 am to 5:00 pm, Monday - Friday.

Primary Responsibilities:

• Analyze benefit requests and secure all necessary data to ensure appropriate implementation based on applied logic of RxCLAIM™ adjudication system
• Implement and maintain benefit requirements within the RxCLAIM™ adjudication system according to the client’s intent and within required turnaround time
• Utilize system tools and follow documented processes to perform job functions
• Work with various cross-functional departments to implement new and maintain existing benefits within the RxCLAIM™ adjudication system including, but not limited to:
  • Client and Pharmacy pricing
  • Formulary updates
  • Clinical programs
  • Specialty drug pricing
• Perform validation of system benefit configuration and claim testing to ensure accurate adjudication
• Perform peer review as assigned
• Research and respond to all claims processing inquiries and issues from various cross-functional departments within required turnaround time
• Adhere to client performance guarantees, when applicable
• Participate in meetings assigned by leadership
• Perform other duties as assigned

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.

Qualifications

• High School Diploma / GED OR equivalent work experience
• Must be 18 years OR older
• 1+ years of healthcare experience
• RxCLAIM™ or other claim adjudication experience
• Proficiency with Microsoft Word (create and edit correspondence) and Microsoft Excel (ability to create, edit, and sort spreadsheets; apply basic analytical formulas)
• Ability to work full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00 am - 5:00 pm local time. It may be necessary, given the business need, to work occasional overtime or weekends.

Preferred Qualifications

• Certified Pharmacy Technician (CPhT)
• Retail pharmacy or PBM experience

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.

Soft Skills

• Experience using critical thinking skills to articulate and inform stakeholders on solutions and issues
• Ability to comprehend, analyze data, and calculate results
• Ability to problem solve and make educated business decisions
• Strong verbal and written communication skills
• Ability to work well independently and as a team
• Maintain a growth mindset
• Excellent interpersonal, organizational, analytical and time management skills as well as the ability to independently manage projects and deadlines
• Proven ability to multi-task with attention to detail, remain focused and motivated in a fast paced, collaborative, and changing environment
• Ability to use tools and technology to perform daily functions
• Experience in implementing and maintaining benefits

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)

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.