Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) Primary Responsibilities: Data File ManagementManages and controls all non-enrollment data, such as claim data, MAC and prescriber data for implementations, on-going plans, plans that are terminating, and request updates or changes for higher profile clients Determines best methods to extract data and input the data into the claims adjudication system accordingly, identifying optimal data file architecture, data processing parameters, and security controls Conducts data analysis during file processing and reports back to clients/vendors on how the data will fit into the system and how it will relate to the plan design that has been set-up as well as recommends solutions that best meet client/vendor and/or company needs Actively participates in the client implementation process, including any necessary conference calls, internal strategy and status meetings, possible onsite client visits, and ongoing project coordination Creates and documents business requirements based on identified technical needs from health plans/accounts, or internal business need Analyzes client data extract activities at a global level to detect trends and key indications of potential issues as well as make recommendations for solutions as necessary Coordinates with system developers, applications/tools and client contacts to setup custom data translation programs for clients who do not utilize company standardsSupport ServicesManages the on-going change control process for established clients to ensure that security and quality of non-enrollment data extract processes are not compromised with consideration made for the real-time nature of pharmacy benefits Assists in maintaining up-to-date standard operating procedures for departmental activities/processes Manages the periodic coordination efforts of new product development, including the coordination of developing automated processes to support new initiatives Supports and maintains new product initiatives as defined by business Participates and provides contributions in various departmental and divisional projects to ensure the constant improvement and innovation of services and processes Troubleshoots issues or inquiries made by internal departments and/or clients pertaining to downstream and peripheral processes that interface with non-enrollment data processes May serve as a resource for peers Provides on-going analysis of general functional processes and will make recommendations for improvement as appropriate Participates in concept, functionality, and innovation pilot programs or testing initiatives Maintains documentation that support business defined standards for inbound and outbound data transactions between company and external clients/vendorsCommunicationServes as a liaison between clients/vendors and company to ensure that all client data requirements are accurately met, complete, and in accordance with designated plan design Collaborates with implementation management and/or client services on the implementation of new accounts as well as initiatives for existing business Collaborates with clients/vendors on company products, services, and standards within non-enrollment data extract management, including standard data formats, exchange protocols, and business program(s) requirement(s) Responds to client/vendors and account management inquiries regarding potential non-enrollment data issues and will troubleshoot for optimal outcomes/resolution Discuss and advise in group/account architecture design process pertaining to non-enrollment data activities, business program requirements, and long-term security/supportability Consults with other departments to retrieve necessary data components needed for various file implementations
Required Qualifications:HS Diploma/GED 3+ years' experience in PBM industry or data analyst experiencePreferred Qualifications:Bachelor's degree Experience with SQL or Ab initio tool Experience in Microsoft Access, Text Pad/Ultra Edits, or TOAD applicationsCollaborates with clients regarding the determination of non-enrollment data files (claim data, MAC and prescriber data, new/existing health plan data etc.) associated to plan step-up based upon the identified business needs. Maintains existing customer accounts and is responsible for the on-going relationship management, issue resolution, and change control management pertaining to non-enrollment data extracts. Conducts meetings and advises clients/vendors on data extract options considering the identified business needs and client/vendor requirements. Analyzes trends, data conflicts, analysis of issues, and general outcomes in order to provide recommendations for improvements and cost saving resolutions. May serve as a key internal resource for peers.UnitedHealth Group is working to create the health care system of tomorrow. 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.
Internal Number: 727403
About UnitedHealth Group
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.