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.
You will enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Lead Financial Pharmacy Audit Strategies
- Demonstrates understanding of relevant organizations’ operations, products and applications, strategies, processes, and/or business priorities to build effective solutions
- Works closely with Clinical Consultant, Pharmacy Audit to identify opportunities to leverage new opportunities to improve recovery outcomes for our clients with focus on new drugs and billing schemes
- Communicates potential impacts and risks associated with implementing proposed solutions to business partners and relevant stakeholders and coordinate implementation of new, or leveraging of existing, capabilities to optimize outcomes related to those solutions
- Assists management with preparing for and/or actively leading presentations to client(s) related to data analytics and forecasts performed and/or results achieved
- Acts as lead SME and owns client requests for audit recovery/revenue analytics
- Provides input into and/or develop relevant policies, procedures, and/or work tools to support new or updated business processes
- Creates and maintains new job aides that pertain to areas of responsibility
- Monitors on-going progress of business processes (e.g., collect and review data; shadow end users; review pertinent metrics) to identify potential challenges, risks, and/or defects of current or new audit algorithms/analytics under beta test
- Collects and interprets data as requested to support wide ranging analytical requests (budget related, productivity related, etc.)
- Self-directed to meet monthly and/or quarterly commitments
- Works with less structured, more complex issues for analysis and resolution
- Demonstrated ability to problem solve with minimum direction from supervisor
- Serves as a resource to others
- Excellent communicator, both oral and written
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:
- BA/BS in Accounting/Finance, Business, Health Sciences, or equivalent experience
- 4+ years of experience with data analytics, preferably in a pharmacy audit environment
- 4+ years of experience with MS Word, Excel, PowerPoint, SharePoint
- Experience with business finance/budgeting strongly
- Healthcare industry experience with an audit/FWA focus
- Working knowledge of MS Project, Access and Visio
- Background that includes demonstration of solid communication skills
Preferred Qualifications:
- Healthcare and pharmacy claims analytics experience
- Team lead or project lead experience
- Solid experience with SQL, Python, R, Tableau and/or Power BI
- Experience analyzing and identifying PBM financial recovery outcomes
- Experience analyzing and tracking business revenue with focus on new drugs and billing schemes
- Experience developing and implementing financial audit strategies
- Proven highly skills in organizing and conducting PBM audit strategies
- Experience presenting financial and audit results to Sr. Leadership
California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $85,000 to $167,300. 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.
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
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.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employers 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 law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment