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. As a Senior Rebate Audit Analyst , you will be vital to our success in achieving the mission of the Client Audit Department to provide best-in-industry audit management services to our internal and external business partners. In addition, you will help strive to ensure Optum Rx is only paying out on confirmed errors to reduce our financial liability and to ensure corrections are made in a timely manner.
This position supports the facilitation of external audits focused on rebate administration (e.g., Rebate Minimum Guarantees, Rebate Billing/Collections, Rebate Credits). This role requires interaction with both internal business partners at various levels of the organization and the external audit community to successfully complete audits. Leveraging a well-established process, individuals in this role support our clients by responding to claim sets, audit reports, and generally being the liaison to the auditing entity.
Primary
Facilitate end-to-end management of external client audits focused mainly on rebate administration Support manufacturer billing rebate audits conducted virtually and, in some cases, physically on-site Request and obtain rebate documentation from internal teams to provide to external audit firms within established turn-around times Read and interpret client contracts, pharmaceutical rebate contracts, and rebate reporting Perform research to ensure claims were accounted for correctly in minimum rebate guarantee reconciliations Respond to claim sample inquiries and audit reports from external audit firms Actively participate on Department projects Consistently meet established productivity, deliverable timeline adherence, and Department quality standards 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
High School Diploma/GED 3+ years of experience in PBM and/or Claims Audit experience 1+ years of Rebate Administration (e.g., Rebate Minimum Guarantees, Rebate Billing) experience Intermediate level of proficiency in project management Intermediate proficiency within Microsoft Office Suite (Excel, Word, PowerPoint). Must know how to use and apply formulas, filters, and sorting techniques in Excel Intermediate level of proficiency with written and verbal communications skills, including preparing, leading, and presenting in meetings with various levels of leadership on complex topics Ability to explain complex topics in a simplified manner for easy understanding Ability to change gears in a high paced, highly functional team Ability to Travel up to 10%
Bachelor's degree Proven track record of effectively managing time, resources, and tasks to achieve hard deadlines Experience facilitating PBM audits; specifically, rebate administration audits Experience interpreting Rebate Minimum Guarantees in client contracts Ability to interpret pharmaceutical manufacturer rebate contract language (e.g., base rates, price protection, manufacture administration fees) Experience working in Rebate Billing Systems Experience working with upper leadership and presenting confidently on complex issues Experience leading projects lasting three months or longer Certified Pharmacy Technician Internal or Quality Auditing experience *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives.
The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace.
Candidates are required to pass a drug test before beginning employment. #RPO #GREEN