In this role, you will focus on UnitedHealthcare Medicare & Retirement Pharmacy Services Management. If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm) Primary Responsibilities:Responsible for end-to-end business process activities - creating, controlling and improving business processes around pharmacy benefits, eligibility, and the coordination of benefits Ensure eligibility and other health information is loaded accurately and timely end-to-end to ensure accurate point of sale and/or retrospective handling of pharmacy claimsEnsure all errors are resolved timely and source system problems are escalated and supported through resolutionDiagnose process improvement opportunities through research and analysis of data Advocate for new ideas and process improvements to close gaps, reduce manual efforts, and enhance the member experienceDocument processes to reduce operational ambiguity and manage changeCollaborate within the organization to implement changes required due to process, product and/or annual changesReview business requirements for system enhancements or changes; create and execute test scenarios in a timely mannerFocus on improving the member experience and increasing the quality/effectiveness of the Pharmacy Benefit Operations teamApply a basic, structured, standard approach to work
Required Qualifications:Bachelor's degree or High School Diploma/GED with 3+ years equivalent work experience1+ years of experience with data analysis and reconciliation in a healthcare business1+ years of experience documenting processes and writing business requirementsIntermediate or higher level of proficiency with Microsoft Excel and/or Access Preferred Qualifications:Proven history for successfully prioritizing multiple tasks, priorities, projects, and deadlinesExperience in pharmacy operations, PBM or health care operations Experience related to benefits, eligibility or COB (coordination of benefits) Knowledge of Medicare Part D requirementsIntermediate or higher level of proficiency with SharePoint, Microsoft Office, Project, Word, PowerPoint, and Visio Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm) 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. Keywords: Process, Business Analyst, Horsham, PA, Pennsylvania, process improvement, requirements, PBM, pharmacy, Medicare Part D, COB, health care
Internal Number: 750201
About UnitedHealth Group
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.