Position Description: Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. Serve as the primary OptumRx contact for tactical, day to day management of assigned accounts. Manage assigned accounts according to an agreed upon strategy with the goal of retaining >90% of client lives. The Client Service Analyst will manage ongoing contract relationships and service delivery to clients for one or more accounts. Acts as outward-facing, dedicated resource for assigned accounts, typically with direct client contact (not call center) and large or complex accounts. Builds relationships with employer / group clients (not individual members) and serves as the primary point of contact for overall and day-to-day service delivery. Represents client internally and coordinates with other functions to implement client systems, complete projects, and address ongoing service needs. This function includes employees who are in dedicated on-site service roles. Jobs in this function may work closely with sales on renewals and upselling, but incumbents do not have specific sales goal accountability or primary responsibility to close sales. Account management jobs focused primarily on relationship and service management belong in this family; jobs with significant sales responsibilities or sales-related incentives (including 'OTH' plans) belong in a sales band. PrimaryResponsibilities:
Maintain documentation of most current benefit designs, including exclusions, inclusions and co-pay structures; ensure information is accessible to Customer Service and Pharmacy Technicians
Document plan change requests from clients and obtain appropriate approval, update the Benefit Design Summary on the web, and confirm the plan change is completed and accurate
Review Benefit Design Summary documents at least annually with clients and obtain appropriate client signatures of approval
Maintain consistent and regular client communication.
Prepare quarterly client status briefs, including identification of cost drivers, recommendations for cost savings opportunities, utilization reports, Rx Updates, and Catamaran Rx news.
Conduct regular on-site or telephonic client meetings to proactively review client benefits and drug utilization
Establish multiple corporate relationships and participate in client sponsored events; cultivate relationships
Work with Strategic Account Executive, and other team members on client renewals and renegotiating contracts with clients to obtain extended agreements while meeting revenue goals
Understand and execute the client contract according to the terms and conditions, including but not limited to the monitoring and reporting of performance guarantees
Support client open enrollment process by preparing communication materials and attending open enrollment meetings
Follow all policies and procedures related to job responsibilities and participating in the development and maintenance of departmental policies and procedures, and tools for Client Services, as appropriate
Conduct claims research and member inquiries
Ensure open client requests and requirements are routed and being worked by appropriate business area
Track and report on open client requests providing regular feedback to management team regarding client requirement status and business development opportunities
Provide training and support as needed
Educate and assist clients in using help desk for day-to-day inquiries
Assist in client training for remote system access and reporting
Participate in sales preparation meetings and finalist sales presentations as necessary; regularly attending and actively participating in company meetings as requested
Ensure quick response and follow-up to client inquiries, including returning phone calls and emails within 2 hours and attempted resolution of all issues in less than 48 hours. Notify client after issue resolution within timeframe defined by client contract
Participate as preceptor / mentor to new staff as requested, assist in the development of training topics and materials for coworkers, and provide support to other departments as requested
Escalate client concerns where appropriate
Complete service requests to translate customer needs and requirements for Optum's product support and development teams
UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.
We are committed to introducing innovative approaches, products and services that can improve personal health and promote healthier populations in local communities. Our core capabilities... in clinical care resources, information and technology uniquely enable us to meet the evolving needs of a changing health care environment as millions more Americans enter a structured system of health benefits and we help build a stronger, higher quality health system that is sustainable for the long term.
We serve our clients and consumers through two distinct platforms:
?UnitedHealthcare, which provides health care coverage and benefits services.
?Optum, which provides information and technology-enabled health services.