Senior Financial Claims Analyst - Pharmacy or Benefits

Use your Sharp Analytical Skills to research, review, compile, and report key information.Make solid assessments based on data analysis and provide the Account Team with clear reporting and explanation to help support our commercial clients' needs.

As a Senior Business Analyst, you will grow and develop as you conduct and manage outcomes of various research and analytics.You will be challenged to review, analyze, and validate data impacting members, clients, OptumRx, and/or business processes.You will also play a key role in creating automation of forms, templates, and other tools in support of team processes.As a key resource, you must be organized, maintain a high degree of accuracy along with attention to detail, have excellent oral and written communication skills, strong interpersonal skills, and the ability to always meet deadlines.Success in this role will require ability to prioritize, be flexible, resourceful, dynamic, and self-driven!

Primary Responsibilities:

·This role will support the Commercial book of business and associated teams

·Investigate member and client issue remediation by reviewing and analyzing pharmacy claims identifying patterns and trends, such as effects of patient pay components, drug cost changes, and accumulator balance impacts

·Closely collaborate with our internal team, the account team, and other functional departments

·Provide explanations, interpretations, and recommendations related to analysis results as needed for account teams, external clients, and consultants

·Demonstrate and apply understanding of health care industry trends and their drivers

Required Qualifications:

• 3+ years of experience in an analytical role related to Finance, Claims, Pharmacy, or PBM
• 2+ years of experience analyzing large data sets (ie claims) to find patterns, errors, trends, anomalies (pharmacy, finance, or accounting preferred)
• Expertise in data scrubbing and manipulation to identify and resolve inconsistencies and anomalies with the ability to demonstrate before and after scenarios
• Proven solid Microsoft Excel Skills (e.g., complex conditional formulas, nested formulas, V-lookups, pivot tables, etc.)

Preferred Qualifications:

• Financial/Accounting/Remediation experience
• Experience with SQL: knowledge of tables and joins, writing query statements
• Experience with RxClaim
• Experience in Microsoft Access: create tables, queries, joins, data manipulation
• Knowledge of PBM and pharmacy benefit structure
• Proven to be self-directed, works with minimal guidance, but recognizes when guidance needed
• Proven excellent communication, time/project management, problem solving, organizational, and analytical skills

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.

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