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Pharmacy Audit Representative - Irvine, CA

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Careers with OptumRx. We're one of the largest and most innovative pharmacy
benefits managers in the US, serving more than 12 million people nationwide.
Here you ll fill far more than prescriptions. As a member of one of our
pharmacy teams, you re empowered to be your best and do whatever it takes to
help each customer. You'll find unrivaled support and training as well as a
wealth of growth and development opportunities driven by your performance and
limited only by your imagination. Join us. There's no better place to help
people live healthier lives while doing your life's best work.(sm)

Primary
Responsibilities:

  • Positions
    in this function analyze and monitor claims against fraud, waste and abuse
    related to network pharmacies
  • Investigates,
    reviews and analyzes claims data applying knowledge of pharmacy policy and
    practice and data mining techniques to determine details of fraudulent,
    erroneous, or abusive billing activity on Real Time Application System and
    various reports
  • Auditor
    will need to identify and documents fraudulent or erroneous activities
    determined as a result of their work. Auditors typically are licensed
    pharmacy technicians with in - depth knowledge of pharmacy
    operations

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 (or higher)
  • 1+
    years Pharmacy Technician experience in a retail pharmacy environment or
    some type of specialized pharmacy
  • Pharmacy
    Technician License that is current and valid in the state of California
  • Basic
    experience in Microsoft Word (creating / updating documents) and Microsoft
    Excel (creating / updating spreadsheets, pivot tables, and formulas)

Preferred
Qualifications:


  • National
    Pharmacy Technician Certification
  • Experience
    with Specialty Pharmacy
  • Experience
    with Medicare Part D and B
  • Pharmacy
    Benefit Management (PBM) knowledge / experience

Soft Skills:


  • Excellent
    written and verbal communication skills
  • Demonstrated
    ability to organize material from various, sometimes unrelated sources,
    analyze and draw logical conclusions

UnitedHealth Group is working to create the health care system of
tomorrow.

Already
Fortune 6, we are totally focused on innovation and change. We work a little
harder. We aim a little higher. We expect more from ourselves and each other.
And at the end of the day, we're doing a lot of good.

Through
our family of businesses and a lot of inspired individuals, we're building a
high-performance health care system that works better for more people in more
ways than ever. Now we're looking to reinforce our team with people who are decisive,
brilliant - and built for speed.

Come to UnitedHealth Group, and share your ideas and your passion
for doing more. We have roles that will fit your skills and knowledge. We have
diverse opportunities that will fit your dreams.

View
our COVID-19 Resources Page at: https://info.uhg.com/.

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.

Keywords: California
State Pharmacy Technician License, Pharmacy Technician, PBM, retail pharmacy,
specialized pharmacy, Pharmacy Audit, Representative, Call center, Telephonic
customer service, customer service, UnitedHealth Group, UnitedHealth, OptumRx,
Optum

Pharmacy Audit Representative - Irvine, CA

United Health Group
Irvine, CA
Full Time

Published on 01/23/2021