Demo

Senior Technical Product Operations Specialist - National Remote

UnitedHealth Group
Hartford, CT Remote Full Time
POSTED ON 2/23/2025
AVAILABLE BEFORE 5/21/2025

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 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.

PPE (Pre and Post Edit) is a comprehensive pharmacy claim solution designed to increase third-party reimbursements and improve in - store productivity. Our intelligent edit engine provides real - time pre and post edits on prescription claims prior to being sent to and received from the third party processor. The primary responsibility of the Senior Technical Product Operations Specialist - Pharmacy PPE is to support eRx Edit client messaging solution. The Senior Technical Product Operations Specialist will be the technical escalation point within the team for configuring and maintaining pre and post edits using the pharmacy network rules processing engine. This includes assisting clients and internal staff with most complicated edit requirements and providing advanced level guidance on setup and configuration. This role supports our overall technical support as part of a value - add service package delivered to clients such as, trouble shooting, performing quality control / quality assurance, processing change requests, and verifying new edit requirements are documented clearly and follow internal standards. This position will require working effectively and collaboratively with team leaders and other stakeholder disciplines such as Engineering, Account Management, Quality Assurance, and any other representative that can add value to the task at hand.

This position is full time, Monday - Friday. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 8 : 00 AM - 5 : 00 PM.

We offer 4 weeks of paid training. The hours of training will be based on your schedule during normal business hours or will be discussed on your first day of employment.

You’ll enjoy the flexibility to telecommute

  • from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities :

  • Master the pharmacy rules processing engine using the Rule Explorer User Interface to configure, manage, and maintain pre and post message edits
  • Work closely with colleagues within the PPE team to provide guidance to less senior level agents for edit implementations and changes
  • Work closely with colleagues within the PPE team to conduct peer review and QA for edit implementations and changes
  • Provide escalated customer support as needed to evaluate edit function and performance
  • Document business rules and edit requirements working closely with internal and external customers and Subject Matter Experts
  • Support the software development process as needed
  • Establish and maintain effective communication with colleagues, internal stakeholders, and clients as needed
  • Must be willing to accept additional duties and responsibilities when necessary
  • 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
  • Must be 18 years of age OR older
  • 5 years of experience in pharmacy OR medical claims editing
  • Experience with Microsoft Word (create correspondence and work within templates), Microsoft Excel (data entry, sort / filter, and work within tables), and Microsoft Outlook (email and calendar management)
  • Ability to work any of our shift schedules during the normal business hours of 8 : 00 AM - 5 : 00 PM from Monday - Friday
  • Preferred Qualifications :

  • Ability to train and mentor others
  • 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
  • Soft Skills :

  • Strong verbal and written communication skills
  • All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
  • The hourly range for this role is $28.61 to $56.06 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and k 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.

    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.

    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.

    Salary : $29 - $56

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