Pharmacy Audit Analyst – Travel Required at UnitedHealth Group

Optum is a world group that delivers care, aided by know-how to assist hundreds of thousands of individuals stay more healthy lives. The work you do with our staff will immediately enhance well being outcomes by connecting folks with the care, pharmacy advantages, knowledge and assets they should really feel their greatest. Here, you will see a tradition guided by inclusion, proficient friends, complete advantages and profession improvement alternatives. Come make an influence on the communities we function you assist us advance well being optimization on a world scale. Join us to begin Caring. Connecting. Growing collectively.  

This place requires journey (by way of automobile, airplane, and practice) inside a selected demographic. Travel requirement could be as much as 75% of the calendar yr.

Primary Responsibilities:

• Complete pre-audit work together with journey planning, supplies gathering and desk audit actions independently and in accordance with established goals
• Perform onsite and desktop pharmacy community audits to determine potential discrepant pharmacy claims
• Assess pharmacy web site’s bodily premises, compliance with regulatory necessities, and completeness of information
• Gather and assessment documentation as much as however not together with prescription hardcopies, signature logs, compounding information, and MARs
• Facilitate solutions to questions from pharmacy community suppliers on a rotational foundation
• Report findings to pharmacy community suppliers
• Reviews and assesses high quality and accuracy of audits carried out (QC)

You’ll be rewarded and acknowledged in your efficiency in an atmosphere that may problem you and provide you with clear course on what it takes to achieve your function in addition to present improvement for different roles chances are you’ll be keen on.

Required Qualifications:

• Current and unrestricted Pharmacy Technician License for the state of residence
• Must be presently licensed by the PTCB (Pharmacy Technician Certification Board)
• Home Location inside 45 miles of International Airport
• 2+ years of expertise working in pharmacy audit, PBM, healthcare investigations, or medical health insurance atmosphere
• 2+ years of expertise able processing pharmacy or medical claims
• Experience with Microsoft Office (Word – creating and modifying paperwork, Excel – creating, filtering, and sustaining spreadsheets)
• Experience working independently and researching/conducting investigations; have to be analytical, self-motivated, objective oriented, and have the power to efficiently examine advanced points
• Experience main in-person and digital/desktop audits
• In – depth information of pharmacy operations
• Work remotely AND journey (automobile, practice, airplane) as much as 75% of the yr

Preferred Qualifications:

• Bachelor’s Degree
• Intermediate stage of information with Local, State & Federal legal guidelines and rules pertaining to medical health insurance (Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy and/or business medical health insurance)
• Proficient in RxClaim or different pharmacy claims processing methods
  Certified Quality Auditor (CQA)
• Proven skill to drawback resolve together with a number of priorities and analysis conflicting and/or inaccurate info

*All staff working remotely might be required to stick to UnitedHealth Group’s Telecommuter Policy

Application Deadline: This might be posted for no less than 2 enterprise days or till a enough candidate pool has been collected. Job posting might come down early on account of quantity of candidates.

At UnitedHealth Group, our mission is to assist folks stay more healthy lives and make the well being system work higher for everybody. We imagine everyone-of each race, gender, sexuality, age, location and income-deserves the chance to stay their healthiest life. Today, nonetheless, there are nonetheless far too many limitations to good well being that are disproportionately skilled by folks of coloration, traditionally marginalized teams and people with decrease incomes. We are dedicated to mitigating our influence on the atmosphere and enabling and delivering equitable care that addresses well being disparities and improves well being outcomes – an enterprise precedence mirrored in our mission.    

Pay relies on a number of components together with however not restricted to native labor markets, training, work expertise, certifications, and so on. In addition to your wage, we provide advantages akin to, a complete advantages package deal, incentive and recognition packages, fairness inventory buy and 401k contribution (all advantages are topic to eligibility necessities). No matter the place or if you start a profession with us, you may discover a far-reaching selection of advantages and incentives. The wage for this function will vary from $49,700 – $88,800 yearly based mostly on full-time employment. We adjust to all minimal wage legal guidelines as relevant.

UnitedHealth Group is an Equal Employment Opportunity employer underneath relevant regulation and certified candidates will obtain consideration for employment with out regard to race, nationwide origin, faith, age, coloration, intercourse, sexual orientation, gender id, incapacity, or protected veteran standing, or some other attribute protected by native, state, or federal legal guidelines, guidelines, or rules.

UnitedHealth Group is a drug – free office. Candidates are required to move a drug take a look at earlier than starting employment.