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Senior Business Analyst - Telecommute

Company: UnitedHealth Group
Location: Irvine
Posted on: November 18, 2021

Job Description:

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) -- The Senior Business Analyst is responsible for designing/developing, maintaining, and documenting processes for internal database relevant to Healthplan team's Project support and Training and Development. This position provides operational analysis utilized for decision making, makes recommendations based on the analysis and provides explanations for output results as needed.-- -- --You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.-- -- Primary Responsibilities:

  • Serve independently as PDL/Drug List implementation and pharmacy program subject matter expert for UHCEI plans
  • Based on health plan PDL/Program designs, identify complexities, interactions amongst programs, and requirements for program implementations/changes and submit tickets to appropriate PBM functional teams (Benefit Operations/Formulary Operations) to effectuate drug list creation or change (on/off cycle changes)
  • Identify appropriate GPI/NDC's and level
  • Identify appropriate plan types for change
  • Utilize appropriate ticket templates and checklists
  • Facilitate required member level overrides
  • Facilitate process changes and maintenance of programs-- --
  • Proactively Identify PDL/Drug List implementation risks, implement a mitigation/action plan and drive improved outcomes, communicate to senior leadership
  • Manage mass changes to Benefit Codes (BPL) as it relates to new projects, programs or regulatory changes
  • Partner with UHC Pharmacy teams to manage and prioritize PDL/Drug List projects and implement pharmacy benefit solutions
  • Facilitate testing of PDL/Drug List changes
  • Support Service Teams in resolving group and global PDL / Drug Lists inaccuracies
  • SME for all project forums including, but not limited to Demand Management, BDLE, BIP and/or BSRT
  • Lead issue resolution projects
  • Identification of root cause and resolution steps
  • Assess member and or client impact and internal communication needs
  • Assess and facilitate external communication needs
  • Assess and facilitate the need for member mass adjustments or client remediations
  • Monitor, track and report PDL/Drug List implementation status and performance
  • Work with health plan and functional leaders to proactively identify drug list issues and drive their resolution
  • Identifies the need for, Create /maintain SOPs, Job Aids, Process flows and Ticket Templates
  • Develop and maintain strong inter-company--relationships to ensure timely and accurate PDL/Drug List creation, maintenance and issue resolutions
  • Facilitate/Lead meetings at various levels of the organization -- 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. -- -- Required Qualifications:
    • Undergraduate degree
    • 2+ years of PBM experience
    • 1+ years of RxClaim experience
    • Intermediate level or better proficiency in Word, Excel and PowerPoint
    • Experience and ability to work independently
    • Experience utilizing excellent time management skills -- Preferred Qualifications:--
      • Microsoft Access experience
      • Experience as a Pharmacy Technician
      • Experience with E&I Business -- To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment. -- Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) -- *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. -- Colorado, Connecticut or Nevada Residents Only: The salary/hourly range for Colorado residents is--$71,400 to $127,400. The salary/hourly range for Connecticut/Nevada residents is--$71,400 to $127,400. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. -- ---- Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.---------- -- UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.------ -------- ---- Job Keywords:--Senior Business Analyst, PBM, RxClaim, PDL, Implementation, Project Management,--Telecommute, Telecommuter, Telecommuting, Remote, Work from Home

Keywords: UnitedHealth Group, Irvine , Senior Business Analyst - Telecommute, Professions , Irvine, California

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