Business Analyst - Remote Nationwide

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timePosted a day ago location United States salarySalary undisclosed
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Job Description

When you're setting the pace for change, it's not only challenging, it's exhilarating. We're building new health care solutions right and left and shaping the system as we go to help millions live healthier lives. That's why we need Business Analysts who can keep up and dig deep. When you join us, you'll drive processes and improvement initiatives that have an impact on healing the health system. Sound like your kind of challenge? Join a Fortune 6, industry leader and find out how you can be a part of something life changing for millions. Primary Responsibilities Support the collection of data for audit activities Serve as a subject matter expert during audits Lead remediation efforts after audits Review state rules and regulations to determine compliance or necessary steps to become compliant to mitigate risks and achieve compliance with regulatory bodies for both PA and Appeal Establish and implement standard policies, procedures, processes and best practices to promote compliance with applicable laws and contractual obligations for PA and Appeal Use pertinent data and facts to identify and solve a range of problems within area of expertise Investigate escalated issues and recommend process improvement Write Executive summaries and CAPs Assist in implementation of regulatory requirements and accreditation standards Research rules and regulations to write accurate, consistent, and timely responses to questions regarding compliance Review policies for alignment to rules and regulations, as well as alignment to PA and Appeal processes Conduct quality assurance on written output by editing for quality and professionalism Support the collection of information for Optum Licensing Create, update, and preserve team knowledge tools 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 above 1+ years direct experience with Prior Authorization within a PBM or pharmacy Working knowledge of Medicare Part D, NCQA, and State regulations Experience giving presentations Proficiency with Microsoft Word, Excel, PowerPoint, Outlook Ability to travel up to 15% (once Covid travel restrictions are lifted) Preferred Qualifications: RxClaims experience Sharepoint experience Prior Authorization System (PAS) experience UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us. You can learn more about all we are doing to fight COVID-19 and support impacted communities: click here. Colorado Residents Only: The hourly range for Colorado residents is $26.63 to $45.72. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentivesDiversity 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.Job Keywords: Business Analyst, Telecommute, remote, work from home, work at home, WFH, WAH, hiring immediately, Travel,#RPO