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UnitedHealth Group Senior Business Analyst - Telecommute in Irvine, California

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

The Senior Business Analyst (Data and Finance) serves as the expert on the State client’s data interfaces, claims data and finance data requirements. You will work as the liaison between the OptumRx operational staff and the State Staff to ensure we have a documented data exchange strategy and meet the client's needs. You will be responsible for the oversight of all data exchange activity related to the client's pharmacy benefit. You will interact with multiple internal departments to deliver best - in - class service to our client.

As the Senior Business Analyst (Data and Finance) you will be engaged in discussions with the PBM account team, and the clinical team with respect to all data exchanges, and establish QA processes to ensure all data exchanges are complete, accurate and in accordance with client requirements. In addition, you will provide support the Account Team by establishing processes and development of all client required reporting and be responsible for running and scheduling all reporting in the reporting system as well as working with the OptumRx reporting team in the development of all ad hoc reporting required to meet the client’s needs. This position requires a high performing individual with proven communication skills and a comprehensive understanding of finance processes, file requirements and layouts and analytical skills.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Oversight of all data and file exchanges processes

  • Work with finance team to provide quarterly reporting regarding pricing guarantees

  • Work with the Network Team to track and analyze changes to participating pharmacy contracts and assess an financial impact

  • Be the main contact for the State Controller’s office on ensuring timely payment to the pharmacies

  • Support Account Team related to establishing, tracking and process for all client reporting and analysis

  • Generate the Quarterly Business review reporting

  • Ensure the quality of the data reporting

  • Support the account team with Adhoc reporting requests

  • Regularly attend and actively participate in company and client meetings as requested

  • Exhibit compliant and ethical behavior in the performance of job responsibilities, including complying with all applicable federal and state laws and regulations, OptumRx Code of Conduct, Business Ethics Policies and Procedures and other policies and procedures applicable to position

  • Perform other duties as assigned to meet corporate objectives

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:

  • Bachelor's Degree

  • 5+ years of experience with SQL

  • 5+ years of experience with Access

  • 5+ years of experience with Excel

  • 2+ years of experience with reporting, data analysis, and file exchanges

  • 2+ years of experience with project management skills

  • Experience handling and resolving complex client issues

  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

  • MBA

  • SAS certified

  • 2+ years of claims analysis experience

  • 2+ years of experience in benefit file exchange business requirements, File Transfer protocol knowledge

  • 2+ years of experience with working with Tableau

  • 2+ years of experience with working with Aginity

  • 2+ years of experience with working with MySQL

  • RxClaim experience

  • Experience solving practical issues and deal with many variables in situations where only limited standardization exists

  • Experience developing and establishing proactive oversight processes to ensure contractual compliance

  • Experience interfacing with clients at the C level

  • Advanced knowledge of (SQL)

  • Proficient knowledge of the PBM industry

  • Able to modify existing SQL queries and create query code from scratch

  • Demonstrates a high degree of client focus and attention to service

  • Knowledge of Medicare Part D Employer Group Waiver enrollment and claims processing rules

  • Understanding of pharmacy benefit strategies and pricing practices

  • Strong business and financial acumen

  • Excellent written and oral communication skills

Careers with OptumRx. We're one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here you’ll fill far more than prescriptions. As a member of one of our pharmacy teams, you’re empowered to be your best and do whatever it takes to help each customer. You'll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There's no better place to help people live healthier lives while doing your life's best work.(sm)

Colorado Residents Only: The salary range for Colorado residents is $64,800 to $116,000. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and 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.

Job Keywords: Reporting, Business Analyst, Reporting, Data Analysis, File Exchanges, Project Management, SQL, MS Access, Excel, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote