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UnitedHealth Group is a healthcare and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of
Install Specialist
Location
United States
Posted
16 days ago
Salary
$24 - $43 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Install Specialist
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 Install Specialist 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. 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 local time. It may be necessary, given the business need, to work occasional overtime. This will be on-the-job training and the hours during training will be 8:00 am to 5:00 pm local time, Monday - Friday. Primary Responsibilities: - Analyze benefit questions and secure all necessary data to ensure appropriate implementation based on applied logic of RxCLAIM adjudication system - Implement and maintain benefits 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 benefits 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 of age OR older - 1+ years of experience in a PBM (Prescription Benefit Management) environment performing a benefit-related function - Experience using critical thinking skills to articulate and inform stakeholders on solutions and issues - Experience analyzing data, calculating results and problem-solving within a role - Capability to use tools and technology to perform daily functions - Microsoft Office proficient - Microsoft Word, Microsoft Excel, and Microsoft Outlook including the ability to open, create, edit, save, and send documents, spreadsheets, and emails - Ability to work through peak season (October to January); overtime may be mandated along with limited PTO availability - Ability 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) - RxCLAIM or other claim adjudication experience - Retail pharmacy or PBM experience - Experience in implementing and maintaining benefits 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 - Demonstrated verbal and written communication skills - Proven ability to work well independently and as a team - Proven ability to multitask with attention to details, remain focused and motivated in a fast-paced, collaborative, and changing environment - Maintain a growth mindset - Excellent interpersonal, organizational, analytical and time management skills as well as the ability to independently manage projects and deadlines 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.
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