Find your next great job

A daily email of jobs matching your skills and preferences.

Sign Up 👋

Remote Medicare Business Process Analyst

Posted about 2 years ago

Business Process Analyst, Medicare - Telecommute (843893)

Position Description

This role is the client's

window into the OptumRx PA organization. The Business Process Analyst will stand in the gap' with the AM Teams and client and the PA Organization to educate and assist with information. Individuals need to think critically and

function independently and be able to offer solutions and resolution on the fly

to clients with minimal supervision. Work internally with all PA groups and external to PA partners to ensure new

and existing clients / members are experiencing the best possible outcomes based

on contractual obligations, etc.

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

Primary Responsibilities:

Individuals need to think critically and function independently and be able to offer solutions and resolution on the

fly' to clients with minimal supervision

Manage and lead the education of new client and existing client updates by delivering, on time, client implementations and

Prior Authorization projects, ensuring that all required tasks necessary to

implement the client or onboard existing client update is complete

Own the client / AM relationship from the PA

perspective and communicate action items to the business while holding the

account teams responsible accordingly

Work with PA internal and external partners

to ensure new clients are serviced based on contractual obligations, etc. to

ensure proper workflow for Prior Authorization Operations Team, help identify

process improvements etc.

Collaborate with all applicable teams across

the enterprise to service new clients and maintain existing clients excellent

service levels

Review all material as it pertains to onboarding new clients / maintaining existing clients to ensure they can be compliant and operationally and technically - sound

Participate in weekly internal and external meetings for all manner of client needs

Available for travel to client for meetings from time to time

Review internal JAs / CPDs throughout the year to ensure no updates to process /

procedures, etc.

Resolve ServiceNow requests and ServiceNow Tasks / metrics are on track

(maintain zero % overdue)

Assist with Research and Resolution team with questions

Assist with the RFP/RFI process (current and potential clients)

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:

3 years of experience in Prior Authorization or Operations or Account Management

Experience working with Medicare Part D (Chapter 18) and NCQA

Advanced level of proficiency with PC based software programs and automated database management systems (Excel, Access, PowerPoint, Word)

Preferred Qualifications:

Demonstrated process improvement, workflow, benchmarking and / or evaluation of business processes

Excellent communication, presentation, leadership, time/project management, problem solving, organizational, and analytical skills

At UnitedHealth Group we're rewriting the way health care gets done for millions. Be part of something daring and bold while doing your life's best work.(sm)

UnitedHealth Group is working to create the health care system of tomorrow.

Already Fortune 6, 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.

*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: Business Process Analyst, Medicare, Telecommute, Telecommuting, Working from Home, BA Prior Authorization

Requisition Number 843893

Job Title Business Process Analyst, Medicare - Telecommute

Job Family Business Operations

Business Segment OptumRx

Job Location Information

Schaumburg, IL

Additional Job Detail Information

Employee Status Regular

Schedule Full-time

Job Level Individual Contributor

Shift Day Job

Travel No

Telecommuter Position Yes

Overtime Status Exempt

Apply Now! 🤞

A new window will open to the job source site.

Job research tailored to you.

Growing a career that's right for you is a life-changer, but it's undeniable that the job search gets tougher every year. With automated hiring processes, resume filters and questionable interview practices, finding a job that a tech skillset has become seriously challenging.

That's where we step in. Careeriscope can help lighten the stress load by making your search a bit easier. We help you find matches based on the job search criteria you set, then send a summary of the results in a daily email sent every morning for review.