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Pharmacy Service Specialist - Richardson, TX
| Hours | Full-time, Part-time |
|---|---|
| Location | Richardson, TX Richardson, Texas |
About this job
Energize your career with one of Healthcare's fastest growing
companies.
You dream of a great career with a great company - where you can
make an impact and help people. We dream of giving you the opportunity to
do just this. And with the incredible growth of our business, it's a
dream that definitely can come true. Already one of the world's leading
Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate
our Service Centers, improve our Service levels and help people lead healthier
lives. We live for the opportunity to make a difference and right now, we are
living it up.
This opportunity is with one of our most exciting business areas:
Optum - a growing part of our family of companies that make UnitedHealth Group
a Fortune 14 leader.
Optum helps nearly 60 million Americans live their lives to the
fullest by educating them about their symptoms, conditions, and treatments;
helping them to navigate the system, finance their Healthcare needs, and stay
on track with their Health goals. No other business touches so many lives in
such a positive way. And we do it all with every action focused on our shared
values of Integrity, Compassion, Relationships, Innovation, and Performance.
Candidate must be able to sit 75% of their 8 hour shift. Be able to receive, understand and implement operating procedures. Receive client pharmacy benefit set up and updates and interrupt them using pharmacy knowledge. Able to multitask with various applications and internal departments in able to resolve complex pharmacy benefit set up issues.
Primary Responsibilities:
- Conduct Eligibility Reconciliation.
- Conduct Accumulator Reconciliation.
- Oversee Mass Adjustments.
- Support Operational training on PBM systems such as RxClaim, IFMS, PAS, RxExpress, and/or IRIS.
- Support the creation, maintenance, and organization of SOP's, P&P, and business process flows.
- Support File Feed set up and maintenance.
- Support DMHC / NCQA / URAC and other client Audit activities.
- Support Health Care Reform implementations.
- Support Regulatory reporting.
- Manage process for Appeals &/or Grievance reviews.
- Support implementation of new Pharmacy products &/or services.
- Identify trends, document lessons learned, and drive continuous service, client, &/or customer process improvement.
- Represent OptumRx to UHC Operations Teams (PRIME, ACIS, CDB, TOPS, CAMS).
- Provide support to the Client Service and Account Service Teams in the management of member- and customer-specific escalated issues &/or service concerns.
- Act as SME for Pharmacy Benefit design, products, and programs.
- Provider support to Client Management Teams for on-boarding of new team members.
- Serve as trainer to Client Management Teams on UHC, UHC Affiliate and Acquired Entity Pharmacy plans and operations.
Requirements
Required Qualifications:
- High School Diploma/GED.
- 1+ year of experience with Microsoft Office: Word (documentation skills); Excel (sorting and filtering).
- 2+ years of work experience with Pharmacy Benefits Management (PBM).
- Experience working in a fast paced environment meeting tight deadlines.
- Professional experience providing Customer Service.
Preferred Qualifications:
- Bachelor's Degree.
- Pharmacy Technician.
- Experience working with Account Management or implementation teams.
- Pharmacy Benefit knowledge.
Careers
with Optum. Here's
the idea. We built an entire organization around one giant objective; make the
health system 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
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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