Senior Pharmacy Audit Representative

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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.^SM

Schedule: Monday - Friday, 8:00am - 4:30pm PST (with a 30-minute lunch). Candidates must be located in PST, CST, EST or MST Time Zone.

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

Primary Responsibilities:

• Positions in this function analyze and monitor claims against potential fraud, waste and abuse related to network pharmacies
• Investigate, review, and analyze claims data applying knowledge of pharmacy policy and practice and data mining techniques to determine details of potential fraudulent, erroneous, or abusive billing activity on Real Time Application System and various reports
• The auditor will need to identify and document potentially fraudulent or erroneous activities determined as a result of their work. Auditors typically are licensed Pharmacy Technicians with in-depth knowledge of pharmacy operations
• Auditors are responsible to achieve assigned goals and meet quality standards for their documentation

What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
• More information can be downloaded at:

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:

• High School Diploma/GED (or higher) OR 2 years of experience as a Pharmacy Technician in a retail pharmacy, PBM or specialized pharmacy
• Active and unrestricted Pharmacy Technician License in state of residence
• Active and unrestricted National Pharmacy Technician Certification (ExCPT or PTCB)
• 2 years of experience with Microsoft Word (creating/updating documents) and Microsoft Excel (creating/updating spreadsheets, pivot tables, and formulas)
• 1 years of Pharmacy Technician experience in a retail pharmacy, PBM or specialized pharmacy
• Flexibility to work as late as 5:00 PM Pacific Time
• Reside in the United States in the Central, Mountain, Pacific or Eastern Time Zone

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

California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island or Washington Residents Only: The hourly range for California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, or Washington residents is $18.80 to $36.78 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

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.

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.

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