Business Process Consultant

This position is National Remote. You'll enjoy the flexibility to telecommute
* from anywhere within the U.S. as you take on some tough challenges. For all hires in Minneapolis, Virginia, Maryland, or Washington, D.C. area, you will be required to work in the office for a minimum of four (4) days per week.

At United Healthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

About United Healthcare Medicare & Retirement

As the largest U.S. business dedicated to serving the rapidly expanding Boomer population, we are committed to improving quality of life for more than 9 million members. Joining our team means contributing to meaningful, long term solutions that strengthen the health care system.



Position Overview

The Business Process Consultant is responsible for overseeing key pharmacy business operations, ensuring regulatory compliance, and driving performance across delegated functions. The role requires strategic thinking, strong problem solving abilities, and the capacity to present insights and recommendations to leadership.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm CST. It may be necessary, given the business need, to work occasional overtime.

We offer on-the-job training. The hours of the training will be based on schedule or will be discussed on your first day of employment.

Primary Responsibilities

• Provide oversight for Government Programs Coverage Determinations, Direct Member Reimbursement (manual claims), and Pharmacy Help Desk operations delegated to the Pharmacy Benefit Manager (Optum Rx) for Part D and Individual & Family Plan products
• Lead operational implementation for new market expansion
• Develop and execute oversight programs to ensure regulatory and contractual compliance
• Monitor business performance and communicate results, risks, and opportunities to leadership
• Identify and lead initiatives to improve operational performance, reduce administrative costs, enhance member and provider experience, and support government audits
• Build effective working relationships within UHC Government Programs Pharmacy and with PBM partners

• High School Diploma / GED
• Must be 18 years of age OR older
• 5+ years of experience in pharmacy business operations
• 5+ years of experience in business analysis
• Experience leading or owning projects, programs, or implementations
• Ability to absorb information, make decisions, and solve complex problems
• Communication and presentation skills
• Intermediate or advanced proficiency with Microsoft Excel and Microsoft Power Point
• Ability to work full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm CST. It may be necessary, given the business need, to work occasional overtime.

• Experience with pharmacy authorizations
• Experience presenting data and recommendations to senior leadership
• Experience working with a Pharmacy Benefit Manager (PBM)

• 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 United Health Group approved high-speed internet connection or leverage an existing high-speed internet service
• All employees working remotely will be required to adhere to United Health Group's Telecommuter…