We're changing the way health care works for the better. That means consulting with our members, partnering with our physicians, and delivering drugs in the most efficient and effective way. Join us and start doing your life's best work.(sm) The Manager of Pharmacy Audit is on the Fraud Waste and Abuse team. It is a home-based telecommuter position servicing the State of New Jersey as the primary client. Candidates must be based within a commutable distance to Trenton, New Jersey. Primary Responsibilities: Serve as the central point of contact and subject matter expert for the State of New Jersey, leading analysis and investigation efforts in pursuit of Fraud Waste and Abuse (FWA) identification Responsible for administering audit plan with the client Drive resolution to key pharmacy audit escalations across business partners such as network compliance and relations, finance, and UHC SIU / PI Collaborate on proactive solutions with client, client services, and legal team related to FWA matters Anticipate the client's needs and proactively builds relationship through ongoing meetings, presentations, escalations, and resolution of issues Design policy and procedures around new FWA initiatives Direct responsibility for metrics, recoveries, and IOI generated under program for the client Assesses and interprets pharmacy audit requirements and needs of client / client account management Collaborate with, and present to, senior business leaders to deliver highlights of emerging FWA trends Adapts department plans and priorities to address business and operational challenges Demonstrated Competencies:Highly flexible, open to change and new information Demonstrated leadership of team and bench strength developmentManages ambiguity, adapting behavior and work methods to changing organization, adapting best practices in all processes Establishes trust and credibility and follows through on commitments Effective data analysis and interpretation skills Ability to focus on key metrics and frame their overall impact on business objectives Uses careful listening, tact, and candor in all communication Demonstrated problem solving skills; ability to dig into the detailsHigh employee engagement and manger index / valuesExcellent presentation skills
Required Qualifications: High School Diploma or equivalent3+ years of experience doing Fraud, Waste and Abuse auditing or analysis within Pharmacy or Healthcare industry Pharmacy Technician Licensure in the state of New JerseyProficiency utilizing MS Office: Word, Excel, PowerPoint and Outlook Experience with data analysis and manipulation of dataReliable transportation to travel to / from client site visits in Trenton, NJ on a bi-weekly basis at minimumAbility to obtain the National Pharmacy Technician Certification within 60 days of hire Preferred Qualifications: National Pharmacy Technician Certification Bachelor's Degree or higherExperience managing a client PBM experienceAdvanced Microsoft Excel skillsMicrosoft Access skills 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. 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.
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.