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.
The Benefit Operations Management (BOM) team is responsible for error free point of sale pharmacy script adjudication. The Benefit Consultant will play a critical role by partnering with clients and Optum Rx stakeholders to gather and document benefits to support pharmacy benefit implementations and ongoing maintenance within the RxCLAIM™ adjudication system. The Benefit Consultants are involved in a high level of client interaction, including documenting and consulting on client plan design. It’s a fast paced, high-volume environment that requires a balance of client demand 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.
Assets needed for a Benefit Consultant including, but not limited to, a high degree of personal accountability, detail oriented, and strong verbal and written skills. Necessities for this position include superior organizational skills, thinking innovatively, and the ability to work on multiple projects simultaneously and prioritize accordingly.
You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Analyze benefit requests and secure all necessary client data to ensure appropriate implementation based on applied logic of RxCLAIM™ adjudication system
Provide consultative services pertaining to benefit set up, new implementations, special projects and issue resolution
Utilize system tools and follow documented processes to perform job functions
Work with various cross-functional departments to document new and existing pharmacy benefits including, but not limited to, Implementation, Account and Clinical teams.
Adapt to new and changing BOM system capabilities
Participate in internal and external client meetings to meet demand
Prepare documentation to share with internal and external clients
Create and maintain internal procedural documents
Support projects and business initiative requirements
Complete assignments timely to meet internal and external demand
Adhere to client performance guarantees, when applicable
Perform quality assurance testing for system enhancements
Participate in meetings assigned by leadership
Perform other duties as assigned
Travel may be required
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:
2+ years of healthcare experience
1+ years of experience with developing processes applicable to the department
1+ years of experience working with stakeholders on solutions and issues
1+ years of client focused experience including the ability to effectively present information and engage client in productive benefit discussions
Intermediate level of proficiency with Microsoft Word (create and edit correspondence) and Microsoft Excel (ability to create, edit, and sort spreadsheets; apply basic analytical formulas)
Preferred Qualifications:
Certified Pharmacy Technician (CPhT)
Retail pharmacy or PBM experience
Client implementation or onboarding experience
Experience with RxCLAIM™ adjudication system
Basic knowledge of Medicare/Medicaid/Commercial pharmacy benefits
Soft Skills:
Critical thinking skills
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 Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
The salary range for this role is $28.61 to $56.06 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
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.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, 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.
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UnitedHealth Group
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