Senior Business Process Analyst
UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.
Position Description:
UnitedHealthcare Medicare Retirement Pharmacy Operations is searching for an expert problem-solver with experience in implementing and managing quality end-to-end business processes to join our Medicare Part D team as a Senior Business Analyst in Horsham, Pennsylvania.
Primary Responsibilities:
- Understand the overall business model of Medicare Part D products and the PBM claim adjudication system and translate concepts into practice
- Support individual and team goals of affordability, excellence, engagement, compliance and growth
- Support short term operational quality initiative business activities - research and analyze benefit and claim data for issue identification and root cause, develop and test interim solutions, manage implementations, and monitor results
- Initiate and manage long term operational quality initiative business goals - develop business case documentation, define business requirements, support business to business specifications, develop and lead user-interface testing, manage project implementation and post-production results
- Work collaboratively with cross-functional and cross-organizational teams - build positive relationships, maintain weekly calls and projects, prioritize tasks and projects to ensure timely implementation and effective resolution
- Review multi-dimensional documentation to determine business impact and end-to-end business engagement points
- Lead and manage readiness activities related to quality and benefit testing supported by the PBM
- Diagnose process improvement opportunities, develop solutions to non-standard /moderately complex problems, provide explanations and information to others on difficult issues, and lead solution implementation in support of continuous quality improvement
- Develop and maintain reporting, analysis, audits to support general management functions
- Assess and interpret customer needs and requirements.
- Work with minimal guidance; seek guidance on only the most complex tasks
UnitedHealthcare Medicare Retirement is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
Imagine joining a group of professionals and clinicians who are working to improve health care for people over 50. Consider the influence you can have on the quality of care for millions of people. Now, enhance that success with enthusiasm you can really feel.
That's how it is at UnitedHealthcare Medicare Retirement. Everyday, we're collaborating to improve the health and well being of the fastest growing segment of our nation's population. And we're doing it with an intense amount of dedication.
Here, you will discover a culture that grows through challenge. That evolves by being flexible. That succeeds by staying true to our mission to make health care work effectively and efficiently for seniors. Put your best to work for us, and discover extraordinary opportunities for growth.
Requirements:
- Bachelor's degree required or HS diploma/GED with 2+ years Medicare Part D and/or PBM experience
- 1+ year of experience in writing business and/or system requirements and business/finance analysis required
- 1+ year of experience with documenting processes and practices, often in accepted project methodology artifacts
- 1+ year experience with performance or oversight of Pharmacy claim analysis and quality practices
- Intermediate level of proficiency with MS Project, Word, Excel
Assets:
- Knowledge of end-to-end business engagement points for IT related projects
- Familiarity with project initiation documents and processes - B2B, BRD, Business Case and CBA
- Understanding of RSA process for developing and selecting solution options for business problems
- MS Access and Visio
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Additional Information:
- Travel Percentage: 25%
