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SalaryOptum 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 diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
This position is full - time. Employees are required to work any shift between the hours of 8:00am - 5:00pm CST / EST (local time, open to Central / Eastern Standard Time) including the flexibility to work occasional overtime based on business need.
We offer weeks of on-the-job training. The hours of the training will be aligned with your schedule.
You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Serve as the primary OptumRx contact for tactical, day to day management of assigned accounts
- Manage assigned accounts according to agreed strategy
- Maintain documentation of most current benefit designs, including exclusions, inclusions and co - pay structures; ensure information is accessible by Customer Service and Pharmacy Technicians
- Document plan change requests from clients and obtain appropriate approval, update the Benefit Design Summary on the web, and confirm the plan change is completed and accurate
- Maintain consistent and regular client communication
- Establish multiple corporate relationships and participate in client sponsored events; Cultivate relationships
- Support Strategic Account Executive, and other account team members on client renewals and renegotiating contracts with clients to obtain extended agreements while meeting revenue goals
- Understand and execute the client contract according to the terms and conditions, including but not limited to monitoring performance guarantees
- Follow all policies and procedures related to job responsibilities and participating in the development and maintenance of departmental policies and procedures, and tools for Client Services, as appropriate
- Conduct claims research and member inquiries
- Ensure open client requests and requirements are routed and being worked by appropriate business area
- Track and report on open client requests providing regular feedback to management team regarding client requirement status and business development opportunities
- Educate and assist clients in using help desk for day - to - day inquiries
- Assist in client training for remote system access and reporting
- Participate in sales preparation meetings and finalist sales presentations as necessary; regularly attending and actively participating in company meetings as requested
- Ensure quick response and follow - up to client inquiries, including returning phone calls and emails within the scope of the service level agreement
- Notify client after issue resolution within timeframe defined by client contract
- Escalate client concerns where appropriate
- Complete service requests to translate customer needs and requirements for Optum's internal teams
- Other duties as assigned
Required Qualifications:
- High School Diploma/GED (or higher)
- 2+ years of direct client facing experience in Health Care Lines of Business (for example Medicare, Medicaid, and Commercial Lines of Business)
- 2+ years of PBM experience
- 2+ years of experience in the pharmaceutical industry
- Intermediate level of proficiency with Microsoft Office products
- Ability to work any shift between the hours of 8:00am - 5:00pm CST / EST
Preferred Qualifications:
- Knowledge of guidelines for client contracts
- Drug knowledge
- Knowledge of Medicare Part D and / OR other regulatory guidelines
- May require travel up to 10% of the time
Telecommuting Requirements:
- Ability to keep all company sensitive documents secure (if applicable)
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
- All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
#RPO #Green
