Business Operations Specialist - Costa Mesa, CA - Full-time / Part-time

We'll put you in the driver's seat on vital projects that have strategic importance to our mission of helping people lead healthier lives. Yes, we share a mission that inspires. We need your organizational talents and business discipline to help fuel ours. It's the opportunity to do your life's best work.(sm)

Primary Responsibilities:

• PAS Decision Tree Guideline Maintenance

• Datatable Maintenance

• Enhancements and ProTraks

• Identify, resolve, and escalate business and operational
  issues

• Validation of information and rules from Development:
  Stage - Production

• Validation of RxClaims modifications

• PAS Share Point maintenance

• Communication and Notifications of system outages and
  changes

• Business rules documentation

• Process documentation

• PAS Project updates

• Monitor Prescription Routing

• Production Monitoring (Backend Monitoring)

• Business Rule Updates

• Correspondence set-up and revisions

• Pega PAS Business Support

• Core Competencies:

• Strong writing and documentation skills

• Organizational skills

• Creativity

• Pega PAS Business Support

Core Competencies:

• Strong writing and documentation skills 
• Organizational skills 
• Creativity

Required Qualifications:

• High school education/GED and some college preferred
• 1+ year of well-rounded business knowledge including
  standard and specialty prior authorization
  
• Proficiency in MS/Office (Word and Excel: ( sorting,
  filtering, formulas and pivot tables) is required
• Research experience in AS400/RxClaim
• RxHD experience is required
• Demonstrated to be a strong communicator and
  well organized 

Preferred Qualifications:

• 1+ year of well-rounded knowledge of the Pega or Pega
  Rules Process Commander (PRPC) application
• Well-rounded knowledge of Call Center and Specialty
  Pharmacy Operations
• Knowledge of Center for Medicare Services (CMS)
  Regulations
• Knowledge of Prior Authorization Case turnaround times
  (TAT)
• Business technical knowledge and strong Business-IT
  liaison skills

UnitedHealth Group is working to create the health care system of tomorrow.

Already Fortune 14, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.

Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.