Business Process Consultant

UnitedHealth Group•Tampa, FL

12h•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. For all hires in Minneapolis, Virginia, Maryland, or Washington, D.C. area, you will be required to work in the office for a minimum of four (4) days per week. At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together About UnitedHealthcare Medicare & Retirement As the largest U.S. business dedicated to serving the rapidly expanding Boomer population, we are committed to improving quality of life for more than 9 million members. Joining our team means contributing to meaningful, long term solutions that strengthen the health care system. Position Overview The Business Process Consultant is responsible for overseeing key pharmacy business operations, ensuring regulatory compliance, and driving performance across delegated functions. The role requires strategic thinking, strong problem solving abilities, and the capacity to present insights and recommendations to leadership. 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 8:00 am - 5:00 pm CST. It may be necessary, given the business need, to work occasional overtime. We offer on-the-job training. The hours of the training will be based on schedule or will be discussed on your first day of employment.

Requirements

High School Diploma / GED
Must be 18 years of age OR older
5+ years of experience in pharmacy business operations
5+ years of experience in business analysis
Experience leading or owning projects, programs, or implementations
Ability to absorb information, make decisions, and solve complex problems
Communication and presentation skills
Intermediate or advanced proficiency with Microsoft Excel and Microsoft PowerPoint
Ability to work 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 8:00 am - 5:00 pm CST. It may be necessary, given the business need, to work occasional overtime.

Nice To Haves

Experience with pharmacy authorizations
Experience presenting data and recommendations to senior leadership
Experience working with a Pharmacy Benefit Manager (PBM)

Responsibilities

Provide oversight for Government Programs Coverage Determinations, Direct Member Reimbursement (manual claims), and Pharmacy Help Desk operations delegated to the Pharmacy Benefit Manager (OptumRx) for Part D and Individual & Family Plan products
Lead operational implementation for new market expansion
Develop and execute oversight programs to ensure regulatory and contractual compliance
Monitor business performance and communicate results, risks, and opportunities to leadership
Identify and lead initiatives to improve operational performance, reduce administrative costs, enhance member and provider experience, and support government audits
Build effective working relationships within UHC Government Programs Pharmacy and with PBM partners