Working knowledge of Rx. CLAIM Working knowledge of the Prior Authorization process Working knowledge of Part D Transition policy Youll 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 higher) 2 years of experience in Pharmacy Benefit Management 2 years of exper... more details
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 startCaring. Connecting. Growing together.
The position Client Relations Manager is responsible for interfacing with M&R and IFP (within UnitedHealth Group) and will be involved in issue resolution as it relates to Pharmacy Benefits Management. Responsibility also includes remediation of inappropriately rejected claims, root cause analysis, project management, and identifying areas of improvement to proactively support our client. The individual will confirm issues, document and request reports and close the loop on inquiries.
This position will require extended hours and or weekend coverage during the Medicare Part D peak season (January 1 January 31st) timeframe.
Position may also require extended hours after peak season to support event driven issues on a case by case basis.
Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Working knowledge of RxCLAIM
- Working knowledge of the Prior Authorization process
- Working knowledge of Part D Transition policy
Youll 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 higher)
- 2+ years of experience in Pharmacy Benefit Management
- 2+ years of experience with issue resolution
- 1+ years of experience with RxCLAIM and/or pharmacy claim processing
- 1+ years of experience with the Prior Authorization process
- 1+ years of experience with Part D Transition policy
- Intermediate level of proficiency with Microsoft Office products including Excel, Word and Outlook
- Ability to work extended hours and/or weekend coverage during Medicare Part D peak Season (January 1st through January 31st) and after peak season to support even driven issues on a case by case basis
Preferred Qualifications:
- Demonstrated process improvement, workflow, benchmarking and / or evaluation of business processes
- Prior work experience in a retail pharmacy setting
Soft Skills:
- Excellent communication skills
- Time management
- Project management experience
- Problem solving skills
- Strong organizational skills
- Analytical skills
*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.
For more information on our Internal Job Posting Policy,click here.
California, Colorado, Nevada,Connecticut,New York, New Jersey,Rhode Island, Hawaii orWashington Residents Only:The hourly range forCalifornia, Colorado, Nevada,Connecticut,New York, New Jersey,Rhode Island orWashingtonresidents is $23.22 to $45.43per hour.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, youll 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 everyoneof every race, gender, sexuality, age, location and incomedeserves 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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