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 Senior Installation Administrator is responsible for providing SME assistance to assigned team through daily management of training and problem solving. Additionally, the position is responsible for assisting the manager / supervisor with development, analyses, and implementation of all BOM processes.
This position is full-time, Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am – 5:00pm local time zone. It may be necessary, given the business need, to work occasional overtime and weekends.
We offer on-the-job training. The hours during training will be 8:00am – 5:00pm local time, Monday – Friday.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Lead projects and business initiative requirements
Engage with client by guiding and leading discussions along with supporting implementations
Lead the development and roll out of BOM tools and processes
Motivate and lead team participation to drive achievement of goals and objectives
Ability to research, design, recommend, and implement innovative business solutions to complex benefit challenges
Propose solutions for process improvements to leadership
Utilize project leadership skills for complex client implementations and global project initiatives
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
Perform quality assurance testing for system enhancements
Subject Matter Expert (SME) in new plan builds, updates to existing plans, copy/change requests, and global updates
Mentor and train team members
Participate in internal and external client meetings to meet demand
Prepare documentation detailing plan features to share with internal and external clients
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
3+ years of healthcare experience
2+ years of experience working with RxCLAIM™ adjudication system in a benefit analyst OR related position, including ability to navigate the system and understand the functionality at a plan administration level
Advanced level of proficiency in claims processing and issue resolution
Proficiency with Microsoft Office, including Microsoft Word (create, edit, format correspondence), Microsoft Excel (create, edit, and sort spreadsheets; apply basic analytical formulas) and Microsoft Outlook (compose and respond to email)
Ability to work Monday – Friday, in any of our 8-hour shift schedules during our normal business hours of 8:00am – 5:00pm local time zone, including the flexibility to work occasional overtime and weekends, based on the business need
Preferred Qualifications:
Certified Pharmacy Technician (CPhT)
Retail pharmacy or PBM experience
Current experience with RxConstruct
Current experience with RxServiceNow
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 developing processes applicable to the department
Experience using critical thinking skills to articulate and inform stakeholders on solutions and issues
Proven ability to multi-task with attention to detail, remain focused and motivated in a fast paced, collaborative and changing environment
Ability to comprehend, analyze data, and calculate results
Ability to problem solve and make educated business decisions
Ability to work well independently and actively engage a team dynamic
Excellent interpersonal, organizational, analytical and time management skills as well as the ability to independently manage projects and deadlines
Excellent verbal and written communication skills
Maintain a growth mind set
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
The hourly range for this role is $34.42 to $67.60 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.
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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