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Manager, PA and Appeals - Remote - 2233602

UnitedHealth Group

UnitedHealth Group

Eden Prairie, MN, USA
Posted on Tuesday, July 9, 2024

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

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

Primary Responsibilities:

  • Position coordinates, manages and is accountable for the site operations as well as daily activities and performance of team (3+ staff) and leads 90+ in-direct reports (Technicians)
  • Provides leadership, direction, and guidance to the team to ensure quality, productivity, and regulatory / contractual goals and requirements are met
  • Provides a positive work environment and achieves creativity and teamwork among employees
  • Sets team direction, resolves problems and provides guidance to team
  • Ensures policy and procedures are appropriately followed. Identifies and communicates improvement opportunities and reports to the department Director
  • Participates and provides representation in inter – department meetings and workgroups with the Clinical Services & Client Services teams of OptumRx to ensure Prior Authorization department issues and needs are addressed
  • Participates in quality improvement and process enhancement projects as assigned by management
  • Safety is paramount and it’s important for employees to have a safe and secure workspace and communicate with their leadership when that safety (equipment, system, information) is compromised

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:

  • 3+ years pharmacy practice experience
  • 1+ years of experience leading tasks, staff or projects
  • Proven excellent leadership and interpersonal skills

Preferred Qualifications:

  • 2+ years of operations experience, preferably as a supervisor, business manager or workforce manager
  • Authorization experience
  • Supervisory experience
  • Managed care or PBM experience
  • Former Customer Relations experience
  • Experience operationalizing medication clinical guidelines and / or plan benefits
  • Basic navigation skills with Microsoft Excel (ability to create, edit, and save a basic spreadsheet), Microsoft Word (ability to create, edit, and save a basic document), and Microsoft Outlook (ability to send emails)
  • Able to work 7am to 7 pm with ability to work flexible hours, including weekends

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $88,000 to $173,200 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.