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Pharmacy Audit Representative - Irvine, CA
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Irvine, CA Irvine, California |
About this job
Position Description:
We're
changing the way health care works for the better. That means
consulting with our members, partnering with our physicians, and
delivering drugs in the most efficient and effective way. Join us and
start doing your life's best work.
Primary Responsibilities:
We're
changing the way health care works for the better. That means
consulting with our members, partnering with our physicians, and
delivering drugs in the most efficient and effective way. Join us and
start doing your life's best work.
Primary Responsibilities:
- Positions in this function analyze and monitor claims against fraud, waste and abuse related to network pharmacies.
- Investigates, reviews and analyzes
claims data applying knowledge of pharmacy policy and practice and data
mining techniques to determine details of fraudulent, erroneous, or
abusive billing activity on Real Time Application System and various
reports. - Auditor will need to identifies and
documents fraudulent or erroneous activities determined as a result of
their work. Auditors typically are licensed pharmacy technicians with
in-depth knowledge of pharmacy operations. Nationally certified
technicians and technicians with investigative experience are preferred.
Requirements
Requirements:
Assets:
- High School education/GED
- Basic experience in MS Word and MS Excel
- California Pharmacy Technician License
- 2+ years Pharmacy Technician experience
Assets:
- National Pharmacy Technician Certification (CPhT)
- Experience with Specialty Pharmacy
- Experience with Medicare Part D and B
- Pharmacy Benefit Management (PBM) knowledge/experience
- Experience with Issue Resolution.
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.
Diversity creates a healthier atmosphere: 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.
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.
Diversity creates a healthier atmosphere: 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.
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