Pharmacy Audit Analyst - Travel Required

%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EOptum 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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start %3Cstrong%3ECaring. Connecting. Growing together. %26nbsp;%3C/strong%3E %26nbsp;%3C/span%3E%3C/p%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Cstrong%3EThis position requires travel (via car, plane, and train) within a specific demographic. Travel requirement can be up to 75% of the calendar year.%3C/strong%3E%3C/span%3E%3C/p%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Cstrong%3EPrimary Responsibilities:%3C/strong%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EComplete pre-audit work including travel planning, materials gathering and desk audit activities independently and in accordance with established objectives%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EPerform%3Cstrong%3E onsite %3C/strong%3Eand desktop pharmacy network audits to identify potential discrepant pharmacy claims%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EAssess pharmacy site’s physical premises, compliance with regulatory requirements, and completeness of records%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EGather and review documentation up to but not including prescription hardcopies, signature logs, compounding records, and MARs%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EFacilitate answers to questions from pharmacy network providers on a rotational basis%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EReport findings to pharmacy network providers%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EReviews and assesses quality and accuracy of audits conducted (QC)%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp%3E%26nbsp;%3C/p%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EYou’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.%3C/span%3E%3C/p%3E
%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Cstrong%3ERequired Qualifications:%3C/strong%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3ECurrent and unrestricted Pharmacy Technician License for the state of residence%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EMust be currently certified by the PTCB (Pharmacy Technician Certification Board)%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EHome Location within 45 miles of International Airport%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E2+ years of experience working in pharmacy audit, PBM, healthcare investigations, or health insurance environment%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E2+ years of experience in a position processing pharmacy or medical claims%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EExperience with Microsoft Office (Word - creating and editing documents, Excel – creating, filtering, and maintaining spreadsheets)%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EExperience working independently and researching/conducting investigations; must be analytical, self-motivated, goal oriented, and have the ability to successfully investigate complex issues%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EExperience leading in-person and virtual/desktop audits%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EIn - depth knowledge of pharmacy operations%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EWork remotely AND travel (car, train, plane) up to 75% of the year%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Cstrong%3EPreferred Qualifications:%3C/strong%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EBachelor’s Degree%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EIntermediate level of knowledge with Local, State %26amp; Federal laws and regulations pertaining to health insurance (Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy and/or commercial health insurance)%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EProficient in RxClaim or other pharmacy claims processing systems%3C/span%3E%3Cbr%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3ECertified Quality Auditor (CQA)%3C/span%3E%3C/li%3E%3Cli%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EProven ability to problem solve including multiple priorities and research conflicting and/or inaccurate information%3C/span%3E%3C/li%3E%3C/ul%3E%3Cp%3E%26nbsp;%3C/p%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy%3C/span%3E%3C/p%3E%3Cp%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Cstrong%3EApplication Deadline:%3C/strong%3E 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.%3C/span%3E%3C/p%3E%3Cp style=%22text-align:center;%22%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Ci%3EAt 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. %26nbsp; %26nbsp;%3C/i%3E%3C/span%3E%3C/p%3E%3Cp style=%22text-align:center;%22%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3EPay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from %2449,700 - %2488,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.%3C/span%3E%3C/p%3E%3Cp style=%22text-align:center;%22%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Ci%3EUnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.%3C/i%3E%3C/span%3E%3C/p%3E%3Cp style=%22text-align:center;%22%3E%3Cspan style=%22font-family:Tahoma, Geneva, sans-serif;font-size:10px;%22%3E%3Ci%3EUnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.%26nbsp;%3C/i%3E%3C/span%3E%3C/p%3E