Career Opportunity at UnitedHealth Group Philippines

Courtesy of UnitedHealth Group

CAREER OPPORTUNITY FOR BENEFITS ANALYSTS

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

"Already Fortune 25, 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." - UnitedHealth Group

Responsibilities:

• Analyze benefit requests and secure all necessary data to ensure appropriate. implementation based on applied logic of RxCLAIM (by SXC) pharmacy claim adjudication system. 
• Work with Client Management to implement new and maintain existing benefit plans and client pricing in the pharmacy claim adjudication system. 
• Work with Clinical Pharmacy to implement formulary updates and clinical programs in the pharmacy claim adjudication system. 
• Work with Pharmacy Network Management to implement pharmacy rate changes and network additions in the pharmacy claim adjudication system. 
• Ensure timely communication of any issues and/or information needed to complete a plan request. 
• Develop client specific implementation plans and manage implementation processes in accordance with department protocol. 
• Run queries out of the RxCLAIM adjudication system to secure all necessary information to implement plan requests. 
• Develop and run macros in RxCLAIM to implement plan requests. 
• Perform claim testing to ensure accurate claim adjudication. 
• Maintain acceptable and appropriate quality levels and production turn around times 
• Adhere to all documentation standards within the department. 
• Assist with the development of process improvements for the department. 
• Research and respond to all claims processing inquiries from Client Management, Clinical, and other internal department. 
• Participate in team meetings. 
• May be assigned to work on special projects and business initiatives.


Qualifications:

• Bachelor's Degree in Pharmacy Graduate
• Registered Pharmacist
• Any related experience, BPO preferred
• Good communication skills, verbal and written.
• Experience in using MS Windows based PC skills (Word, Excel, Outlook)
• Understanding of basic medical terminology.

For interested applicants, please email your resume to Dearden Santiago (Recruiter) at Dearden_Santiago@uhgrecruitmentservices.com or you can walk in at UHG Science Hub Tower 1, Campus Avenue corner Turin Street, McKinley, Taguig CIty every Mondays and Wednesdays 10 am to 5 pm. You may also call the contact person at (+632)588-3286.

Source: UnitedHealth Group

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