Pharmacy Audit Analyst

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.

Monday through Friday with 8-hour shifts between the hours of 6am-5pm PST

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

• Identify and document fraudulent or erroneous activities determined as a result of an audit
• Prepare audit reports and determine over payments
• Amends audit reports and determines over payments
• Collaborates with Claims Administration in the reverse and re - billing of overpaid claims
• Coordination of timely closure of audits
• Reviews and analyzes claims data, applying knowledge of pharmacy policy / practice and data mining techniques to determine details of over payment billing activity while assisting with oversight of various audit programs
• Monitors and reports accordingly any compliance issues with regulatory requirement

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.)

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

• Active and unrestricted Pharmacy Technician license in the state of residence
• Active National Certification by the PTCB (Pharmacy Technician Certification Board)
• 2+ years of experience working in pharmacy audit, PBM, healthcare investigations, or health insurance environment
• 2+ years of experience in a position processing/auditing pharmacy claim
• Intermediate level of proficiency with Microsoft Excel
• Ability to work an 8-hour shift, Monday
  - Friday, between the hours of 6 am-5 pm PST
• Ability to train Monday
  - Friday from 8 AM - 5 PM PST
• Must be 18 years of age OR older

• In-depth knowledge of pharmacy operations

* All Telecommuters will be required to adhere to United Health 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 $49,700 to $88,800 annually based on…