Job Description

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 Senior Manager of Pharmacy Audit will be based in our Irvine, California office for local candidates. Telecommuters will be considered for candidates based outside of that area or in other states.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:
* Lead diverse team of investigators and analysts in pursuit of FWA identification
* Responsible for administering audit plan across key clients
* 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 key clients, client services, and legal team related to FWA matters
* Serve as central point of contact and subject matter expert for FWA for key clients
* Anticipate 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 key clients
* 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
* Excellent verbal and written communication skills

Demonstrated Skills:
* Highly flexible, open to change and new information
* Demonstrated leadership of team and bench strength development
* Manages 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 details
* High employee engagement and manger index/values
* Excellent presentation skills

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
* Bachelor's Degree, or higher, required. Equivalent work experience will be considered.
* 3+ years of experience in Pharmacy or Healthcare industry, preferably PBM
* 3+ years of relevant experience managing a team and/or managing a client
* At a minimum, State Pharmacy Technician Licensure and National Certification required, or higher (or ability to obtain within 90 days of hire)
* Proficiency utilizing MS Office: Word, Excel, PowerPoint, Access and Outlook
* Experience with data analysis and manipulation of data
* If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:
* Experience managing a client
* PBM experience

Careers with OptumRx. We're one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here you'll fill far more than prescriptions. As a member of one of our pharmacy teams, you're empowered to be your best and do whatever it takes to help each customer. You'll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There's no better place to help people live healthier lives while doing your life's best work.(sm)

The salary/hourly range for Colorado residents is $79,700 to $142,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy

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.

Job Keywords: Pharmacy, Licensed, Pharmacy Technician, Pharm Tech, National Certification, Fraud, Waste, Abuse, FWA, Investigator, SIU, Auditor, Audit, Medical Records, Manager, Management, Supervisor, Supervisory, Irvine, CA, California, Telecommute, Telecommuter, Telecommuting, Work from home, Work at home, WFH, Remote