Associate Benefit Analyst

UnitedHealth Group•Tampa, FL

2d•$24 - $43•Remote

About The Position

This position is National Remote. You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. 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 start Caring. Connecting. Growing together. This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime and weekends. We offer weeks of on-the-job training. The hours during training will be 8:00am to 5:00pm local time, Monday - Friday. Training will be conducted virtually from your home. You’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.

Requirements

High School Diploma / GED OR equivalent work experience
Must be 18 years of age OR older
1+ years of experience in a healthcare insurance environment
1+ years of experience in a PBM (Prescription Benefit Management) environment performing a benefit related function
Microsoft Office proficient - Microsoft Word, Microsoft Excel, and Microsoft Outlook including the ability to open, create, edit, save, and send documents, spreadsheets, and emails, other forms of documents
Ability to work any of our 8-hour shift schedules during our normal business hours of 6:00am - 5:00pm local time. It may be necessary, given the business need, to work occasional overtime.
Ability to keep all company sensitive documents secure (if applicable)
Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.
Experience using critical thinking skills to articulate and inform stakeholders on solutions and issues
Ability to comprehend, analyze data, and calculate results
Ability to problem solve and make educated business decisions
Strong verbal and written communication skills
Ability to work well independently and as a team
Maintain a growth mind set
Proven ability to multi-task with attention to detail, remain focused and motivated in a fast paced, collaborative, and changing environment
Excellent interpersonal, organizational, analytical and time management skills as well as the ability to independently manage projects and deadlines
Capability to use tools and technology to perform daily functions
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Nice To Haves

Quality assurance experience
Pharmacy Technician and / or CPHT License
Claim processing experience
RxClaim experience
Data Entry experience

Responsibilities

Analyze benefit requests and secure all necessary data to ensure appropriate implementation based on applied logic of RxCLAIM™ adjudication system
Implement and maintain benefit requirements within the RxCLAIM™ adjudication system according to the client’s intent and within required turnaround time
Utilize system tools and follow documented processes to perform job functions
Work with various cross-functional departments to implement new and maintain existing benefits within the RxCLAIM™ adjudication system including, but not limited to: Client and Pharmacy pricing Formulary updates Clinical programs Specialty drug pricing
Perform validation of system benefit configuration and claim testing to ensure accurate adjudication
Perform peer review as assigned
Research and respond to all claims processing inquiries and issues from various cross-functional departments within required turnaround time
Adhere to client performance guarantees, when applicable
Participate in meetings assigned by leadership
Perform other duties as assigned