UnitedHealth Group
Pharmacy Audit Analyst - National Remote
This job is now closed
Job Description
- Req#: 2230998
Employer Industry: Healthcare Services
Why Consider this Job Opportunity:
- Salary up to $94,500 per year
- Opportunity for career advancement and growth within the organization
- Work remotely from anywhere within the U.S.
- Comprehensive benefits package, incentive and recognition programs
- Equity stock purchase and 401k contribution
- Chance to make a positive impact on health equity on a global scale
What to Expect (Job Responsibilities):
- Complete pre-audit work including travel planning, materials gathering, and desk audit activities independently
- Perform onsite and desktop pharmacy network audits to identify potential discrepant pharmacy claims
- Assess pharmacy site’s physical premises, compliance with regulatory requirements, and completeness of records
- Gather and review documentation up to but not including prescription hardcopies, signature logs, compounding records, and MARs
- Facilitate answers to questions from pharmacy network providers on a rotational basis
What is Required (Qualifications):
- High School Diploma/GED (or higher)
- Current and unrestricted Pharmacy Technician license in the state of residence
- Currently certified by the PTCB (Pharmacy Technician Certification Board) or ExCPT
- 2+ years of experience working in pharmacy audit, PBM, healthcare investigations, or health insurance environment
- 2+ years of experience in a position processing pharmacy or medical claims
How to Stand Out (Preferred Qualifications):
- Bachelor’s Degree
- Intermediate level of knowledge with Local, State & Federal laws and regulations pertaining to health insurance
- Proficient in RxClaim or other pharmacy claims processing systems
- Certified Quality Auditor (CQA)
- Ability to problem solve including multiple priorities and research conflicting and/or inaccurate information
#HealthcareServices #CareerOpportunity #CompetitivePay #TrainingProvided #GlobalImpact
We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
UnitedHealth Group Incorporated is an American multinational managed healthcare and insurance company based in Minnetonka, Minnesota.
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