Sr Financial Claims Analyst PBM Or Benefits - Remote - Remote Eligible

Senior Financial Claims Analyst (Pharmacy / Benefits)

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing Together.

We are searching for a Senior Financial Claims Analyst (Pharmacy / Benefits) at OptumRx. This is an internal facing role, meaning you will be working directly with our operational partners. This position requires a high level of analytical skill and unique expertise of benefits. As a key resource, you must maintain a high degree of accuracy along with attention to detail, excellent oral and written communication skills, solid personal work ethic and the ability to manage time to meet deadlines. Solid task prioritization skills and critical thinking skills are a must!

Success in this role will require the following:

• Detail oriented (specifically focused on data accuracy and presentation)
• Ability to manage time efficiently and prioritize effectively to adhere to deadlines
• Ability to multitask in a dynamic setting, flexible to changes, and maintain focus under pressure
• Solid organizational skills to track requests and deliverables
• Must be pro-active and have good problem-solving skills
• Ability to work both independently and within a team setting
• Ability to learn quickly and desire to take on new challenges
• Solid desire to make continuous improvements in all areas of responsibility
• Ability to follow-through, be resourceful and self-driven

Ideally, we are looking for this person to join us in our Cypress, CA office, but we may consider other locations or a telecommuting role for a stellar candidate residing in another location.

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

• Communicate and collaborate with our team
• Support client issue remediation by reviewing and analyzing pharmacy claims (calculating before and after scenarios)
• Review external auditor findings, for either agreement or disagreement
• Research, analyze, and evaluate claims data to identify patterns and validate accuracy
• Work closely with the client account team and other functional departments
• Provide explanations, interpretations, and recommendations for reporting results as needed
• Support various projects with financial impacts as needed

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:

• 4+ years of experience in an analytical role related to Finance, Claims, Pharmacy, or PBM
• 2+ years of experience analyzing large data sets (ie claims) to find patterns, errors, trends, anomalies (pharmacy, finance, or accounting preferred)
• Expertise in data scrubbing and manipulation to identify and resolve inconsistencies and anomalies with the ability to demonstrate before and after scenarios
• Proven solid Microsoft Excel Skills (e.g., complex conditional formulas, nested formulas, V-lookups, pivot tables, etc.)

Preferred Qualifications:

• Financial/Accounting/Remediation experience
• Experience with SQL: knowledge of tables and joins, writing query statements
• Experience with RxClaim
• Experience in Microsoft Access: create tables, queries, joins, data manipulation
• Knowledge of PBM and pharmacy benefit structure
• Proven self-directed, works with minimal guidance, but recognizes when guidance needed

All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.