Pharmacy Enrollment Analyst - San Juan, PR

UnitedHealth Group•San Juan, PR

1d•Onsite

About The Position

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Licensing Specialist, in charge of secondary filings, is responsible for running reports from BLH and analyzing these Secondary Filings using a Tracker to ensure all are accounted for. The Secondary Filings Tracker includes license expiration dates, status of filing, method of license delivery to state, and follow up notes. This is a critical function in maintaining Medicaid provider enrollments as states can deactivate the enrollment if required documents are not received and their records updated timely. There is significant follow up involved to ensure the states have updated their records. This includes making phone calls to state Medicaid agencies and/or following up through email.

Requirements

1+ years of experience in an office environment managing time-sensitive deadlines
1+ years of direct experience with Medicaid and Medicare provider enrollment
Proven solid understanding of regulatory requirements and compliance processes, with proven ability to resolve licensing and compliance issues
Demonstrated experience collaborating with diverse stakeholders in a team-oriented setting
Adept at understanding complex concepts and applying sound judgment in compliance-related scenarios
Available to work (40 hours/week) Monday- Friday during our normal business hours of (8:00am to 5:00pm Central Time)
Demonstrated familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
Professional English proficiency (verbal and written) -English proficiency assessment will be required after application

Nice To Haves

Bachelor’s degree or equivalent experience (Associate’s degree considered)
3+ years of experience with licensing processes and/or application systems
1+ years of experience in a healthcare, insurance, or pharmacy setting
Demonstrated familiarity with Boards of Clinical and Pharmacy website navigation
Experience with clinical credentialing, licensure, or regulatory compliance
Proven solid critical thinking and problem-solving skills to support licensure operations and resolve complex issues independently
Proven effective written and verbal communication skills

Responsibilities

In order to maintain Medicaid provider enrollments for our owned pharmacies, the Government Programs licensing team is required to supply current Board of Pharmacy licenses, city/business licenses, and DEA.
Logging onto a portal and updating the expiration date and uploading the current license(s)
Faxing license to the state
Emailing license to the state
Sending paper license copies to the state
Review all license notifications that are received via mail or email, ensuring that the license is accounted for on the Secondary Filings Tracker and the appropriate secondary filings are entered in BLH, and filing in the applicable pharmacy folder on the shared drive
Maintenance of the BLH database includes adding new records when additional Medicaid enrollments are approved, updating any dates based on information received from states, and running reports to confirm all required information is accurately noted in each record
Review incoming emails regarding portal password resets, access the portals and reset the passwords and update the internal Portal Password Tracker
Ensure the correct pharmacy license is provided to the state Medicaid agency including the correct pharmacy name and renewed expiration date.
Verify the Medicaid ID, NPI and correct pharmacy name are included when sending pharmacy license to the state