Position Description:

Working in Operations at UnitedHealth Group is one of the toughest and mostfulfilling ways to help people, including yourself. We offer the latest tools,most intensive training program in the industry and nearly limitlessopportunities for advancement. Join us and start doing your life's bestwork.(sm) 

Positions in this function are responsible for all aspects of quality assurancewithin the Enrollment & Employer Installation job family. Conducts auditsand provides feedback to reduce errors and improve processes and performance.

Quality Review Responsibilities:

• Perform quality review of new and changed benefit plan set-up for accuracyincluding:
• Review completed projects for accurate implementation based on project requestsreceived
• Perform test claims (as applicable) and document results to ensure requestswere completed accurately in the system
• Perform root cause analysis of errors identified (if applicable)
• Assess and communicate financial impact of the errors identified to BOMmanagement (if applicable)
• Validate audit findings with affected parties and confirm corrected (ifapplicable);
• Recommend solutions to mitigate/fix the errors noted and review them withaffected parties for an agreed upon approach, as appropriate;
• Document work performed and audit results based on pre-determined standards andguidelines.
• May be assigned to work on special projects and business initiatives.
• Reporting
• Assist with inquiries from Proposal Unit, Client Management, Clinical, andother internal partners on data requests including:
• Create spreadsheets and macros, compile, analyze data in an efficient andeffective manner
  
• Present data in a detailed and summary level for different level of reviews
• Provide detailed input to root-cause analysis and resolution for errorsidentified.
• Work within a team to support all quality review data reporting needs withinBOM or special projects.
• BOM
• System Testing

• Perform User Acceptance Testing (UAT) to ensure system changes and/or enhancements are properly tested and acceptable prior to implementation including:
• Develop test plan based on business requirements
  
• Perform regression testing (as applicable)
• Identify, report defects and assign risks (as applicable)
• Clearly document work performed and communicate results to BOM management for review/approval
• Communicate to all BOM staff the impact of the changes or enhancements.
• Actively work together with other business groups within Prescription Solutions
• Basic, structured, standard approach to work.

Requirements:

• An education level of at least a Bachelor's degree OR a high school diploma with 4+ years of PBM or retail experience
  
• 2+ years of RxCLAIM (by SXC) experience
• System testing experience required
• 2+ years PBM or retail pharmacy experience
• Intermediate Word experience
  
• Advanced Excel skills

Assets:

• Certified pharmacy technician preferred
  

OptumRx is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable health care solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance.

OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do. In the largest and most personal sense, your impact can be greater than even you thought at OptumRx.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.