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. 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. 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 6:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime and weekends. We offer weeks of on-the-job training. The hours during training will be 8:00am to 5:00pm local time, Monday - Friday. Training will be conducted virtually from your home. 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. Required Qualifications: - High School Diploma / GED OR equivalent work experience - Must be 18 years of age OR older - 1+ years of experience in a healthcare insurance environment - 1+ years of experience in a PBM (Prescription Benefit Management) environment performing a benefit related function - Microsoft Office proficient - Microsoft Word, Microsoft Excel, and Microsoft Outlook including the ability to open, create, edit, save, and send documents, spreadsheets, and emails, other forms of documents - Ability to work any of our 8-hour shift schedules during our normal business hours of 6:00am - 5:00pm local time. It may be necessary, given the business need, to work occasional overtime. Preferred Qualifications: - Quality assurance experience - Pharmacy Technician and / or CPHT License - Claim processing experience - RxClaim experience - Data Entry 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 mind set - Proven ability to multi-task with attention to detail, remain focused and motivated in a fast paced, collaborative, and changing environment - Excellent interpersonal, organizational, analytical and time management skills as well as the ability to independently manage projects and deadlines - Capability to use tools and technology to perform daily functions *All employees working remotely 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. 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). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will from $23.89 - $42.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 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. 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.

Role Description An OON Analyst is essential for ensuring a company's daily operations run smoothly and efficiently. Their role involves a range of tasks, including: - Managing workflow distribution - Claim reassignment - Data tracking - Daily reporting - Maintaining standard spreadsheets - Providing support and oversight to various departmental queues Serving as a key link between departments, the OON Analyst plays a pivotal role in achieving the organization's operational goals and promoting growth. Qualifications - Minimum High School Diploma or GED - Minimum 2 years of experience in a data tracking and reporting setting - Communication (written, verbal and listening), analytical, organizational, prioritization, technical, etiquette and interpersonal skills - Ability to use Microsoft Teams and related communication applications - Strong Excel knowledge (reading, building, and manipulating reports); including formulas and pivot tables - Ability to track tasks for prioritization, setting deadlines, and maintaining visibility on task progress through platforms like Microsoft Planner, Microsoft Lists, and Outlook calendars - Ability to demonstrate strong technical skills - Ability to work independently and handle confidential information - Ability to work in a fast-paced reporting environment to meet deadlines and production expectations Requirements - Ability to use software and hardware peripherals related to job responsibilities including MS Office Suites with preferred proficiency with Word, Excel, and other database software - Ability to be flexible in quickly shifting priorities and keeping up with changes across multiple tasks in a fast-paced environment while maintaining a positive and cooperative demeanor - Ability to identify issues and escalate for course of action for resolution - Ability to elicit trust and credibility with all levels of the organization - Ability to adjust/alter schedule to meet deadlines - Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone Benefits - Medical (PPO & HDHP), dental and vision coverage - Pre-tax Savings Account (FSA & HSA) - Life & Disability Insurance - Paid Parental Leave - 401(k) company match - Employee Stock Purchase Plan - Generous Paid Time Off -- accrued based on years of service - 10 paid company holidays - Tuition reimbursement - Employee Assistance Program - Sick time benefits -- for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year

CAC Group, part of The Baldwin Group, is a leading insurance broker and advisor that provides expertise and placement capabilities across the spectrum of insurance and capital markets. Our team defines our success. We recruit and retain the industry’s best talent with deep knowledge and experience in their respective segments, products, and industries. We root for each other, as we are all connected and aligned to serving clients in a better and smarter way. Find out more about career opportunities to work with the best team in the industry. Analysts play a critical role in supporting the Transactional Liability (“TL”) Practice by engaging in placements, marketing strategies, underwriting submissions, and facilitating M&A-related processes, contributing to seamless client experiences and successful transactions. Duties & Responsibilities: - Support the TL Team broadly with placing R&W Insurance and other TL insurance products - Assist with organizing and maintaining electronic files, including optimizing filing systems and practices - Prepare draft underwriting submissions, indication comparison charts, and binding packages - Gain familiarity with insurance indication letters / quotes and certain key transaction documents, and ultimately review and summarize certain parts of those documents for draft client communications - Organize underwriting calls with carriers and clients - Coordinate execution of Confidentiality Agreements, Brokerage Agreements, client advisor non-reliance letters, and other engagement materials - Coordinate compliance filings - Assist with invoicing and billing - Review policy documents for accuracy - Complete all post binding subjectivities, such as delivery of data room contents, closing set, and surplus line forms - Maintain databases and processes to track relevant deal related information, client lists, and meetings - Provide support with marketing efforts, including research, creation of marketing materials, white papers, and other draft external communications - Other duties as assigned Qualifications: - Bachelor’s degree required - 0-3 years of experience - Strong command of the Microsoft Office suite - Strong analytical and research skills - Strong verbal and written communication skills, including ability to interact professionally with insurance companies, clients, and client advisors - Strong customer service skills, including via telephone and email - Attention to detail - Entrepreneurial attitude, and ability to prioritize work for multiple projects and meet deadlines - Ability to work collaboratively within a team and to foster teamwork Click here for some insight into our culture! The Baldwin Group will not accept unsolicited resumes from any source other than directly from a candidate who applies on our career site. Any unsolicited resumes sent to The Baldwin Group, including unsolicited resumes sent via any source from an Agency, will not be considered and are not subject to any fees for any placement resulting from the receipt of an unsolicited resume.

• The lead reviewer is accountable for the validation of existing Fraud, Waste and Abuse business rules/leads designed to detect aberrant billing patterns as reviewing incoming referrals • Research and ad hoc report development to identify fraud, waste and abuse schemes and trends • Review company clinical & payment policies to determine the impact of the scheme on Aetna business • Identify all possible issues related to fraud, waste and abuse when reviewing a new lead or referral • Keep current with new & emerging fraud, waste and abuse schemes and trends through training sessions and industry resources • Interpret, analyze and present key findings to internal customers (project team, investigators) providing recommendations based on analytical findings