[Hiring] Business Process Consultant @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. 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.

The Business Process Consultant is responsible for overseeing key pharmacy business operations, ensuring regulatory compliance, and driving performance across delegated functions. The role requires strategic thinking, strong problem solving abilities, and the capacity to present insights and recommendations to leadership.

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.

We offer 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:

• Provide oversight for Government Programs Coverage Determinations, Direct Member Reimbursement (manual claims), and Pharmacy Help Desk operations delegated to the Pharmacy Benefit Manager (OptumRx) for Part D and Individual & Family Plan products
• Lead operational implementation for new market expansion
• Develop and execute oversight programs to ensure regulatory and contractual compliance
• Monitor business performance and communicate results, risks, and opportunities to leadership
• Identify and lead initiatives to improve operational performance, reduce administrative costs, enhance member and provider experience, and support government audits
• Build effective working relationships within UHC Government Programs Pharmacy and with PBM partners

Qualifications

• High School Diploma / GED
• Must be 18 years of age OR older
• 5+ years of experience in pharmacy business operations
• 5+ years of experience in business analysis
• Experience leading or owning projects, programs, or implementations
• Ability to absorb information, make decisions, and solve complex problems
• Communication and presentation skills
• Intermediate or advanced proficiency with Microsoft Excel and Microsoft PowerPoint
• 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.

Preferred Qualifications

• Experience with pharmacy authorizations
• Experience presenting data and recommendations to senior leadership
• Experience working with a Pharmacy Benefit Manager (PBM)

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

Pay and Benefits

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). The salary for this role will range from $91,700 - $163,700 annually based on full-time employment.

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.

Company Description

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.