[Hiring] Senior Pharmacy Audit Representative @UnitedHealth Group

Role Description

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.

Schedule: Monday - Friday, 8:00am - 4:30pm PST (with a 30-minute lunch)

If you are located in the PST, CST, EST, or MST Time Zone, you will enjoy the flexibility to telecommute* as you take on some tough challenges.

• Review and analyze pharmacy claims data, applying knowledge of pharmacy policy and practice and data mining techniques to determine details of potential wasteful, erroneous, or abusive billing activity using the Real Time Application System and various reports.
• Outreach to pharmacies, mostly telephonically, to verify pharmacy billing and have pharmacies correct claims if applicable.
• Use in-depth knowledge of pharmacy operations, drug calculations, and pharmaceutical drug resources to evaluate if pharmacy claims are billed correctly.
• Achieve assigned client goals and expectations.
• Collaborate with fellow auditors to complete assigned work and recovery targets.

Qualifications

• High School Diploma/GED (or higher).
• Active and unrestricted Pharmacy Technician License in state of residence.
• Active and unrestricted National Pharmacy Technician Certification (ExCPT or PTCB).
• 2+ years of experience as a Pharmacy Technician in a retail pharmacy, PBM, or specialized pharmacy.
• 2+ years of experience in Microsoft Word (creating/updating documents) and Microsoft Excel (creating/updating spreadsheets, pivot tables, and formulas).
• Flexibility to work as late as 5:00 PM Pacific Time.
• Reside in the United States in the Central, Mountain, Pacific, or Eastern Time Zone.

Requirements

• All Telecommuters 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.
• The hourly pay for this role will range from $20.38 to $36.44 per hour based on full-time employment.
• We comply with all minimum wage laws as applicable.

Benefits

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays.
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account.
• Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage.
• 401(k) Savings Plan, Employee Stock Purchase Plan.
• Education Reimbursement.
• Employee Discounts.
• Employee Assistance Program.
• Employee Referral Bonus Program.
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.).