Eligibility Business Analyst

UnitedHealth Group•Tampa, FL

1d•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. 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. As an Eligibility Business Analyst you will work on a wide range of activities related to department including strategic planning, analysis, implementations and development of action plans. Works with clients and internal work teams to ensure successful implementation and project work. Develops business requirements for Eligibility within assigned projects and follows them through to production. Troubleshoots and works with clients and / or IT to resolve issues and/or interpret perceived issues. 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 and during peak season during 4th quarter of the year. This will be paid 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
1+ years of experience working directly with external and internal clients
Must possess presentation skills
PBM, Health plan, healthcare OR clinic operations experience
Intermediate level of proficiency with Microsoft Excel, Microsoft Word, and Microsoft Access
Ability to interact one-on-one and consult with all levels of management
Independent worker with communication, writing, time / project management, problem solving, organizational, and analytical skills with the ability to review, identify, and resolve discrepancies
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 and during peak season during 4th quarter of the year.

Nice To Haves

Project Management experience
RxClaim working knowledge given
Experience with SQL OR other data analyzing tool
Ability to navigate and analyze large data files

Responsibilities

Serving as a liaison between clients and OptumRx to ensure eligibility requirements for all pharmacy eligibility setups are accurate, complete, and in accordance with designated plan design
Role requires a strong external client facing ability and demonstrated experienced presentation skills to effectively communicate business requirements, analyze complex data, and drive strategic initiatives. Ideal candidate will also collaborate with both internal and external clients to ensure seamless implementations
Maintaining, loading, and troubleshooting complex client eligibility files by researching and resolving discrepancies with client data to ensure timely and accurate updates to the online claims system
Develops, formats, analyzes, and maintains internal and client eligibility reports. Ensures all fields within the client files are accurate and in accordance with National Council of Prescription Drug Program (NCPDP) standards
This role involves managing external client relationships, delivering presentations, and providing exceptional service to ensure client satisfaction