Associate Benefit Analyst

Responsibilities

• Analyze benefit requests and secure necessary data to ensure appropriate implementation within the RxCLAIM™ adjudication system
• Implement and maintain benefit requirements, including new plan builds, updates to existing plans, and formulary updates
• Perform validation of system benefit configuration and claim testing to ensure accurate adjudication
• Research and respond to claims processing inquiries and issues from cross-functional departments
• Work with various departments to manage client and pharmacy pricing, clinical programs, and specialty drug pricing
• Adhere to client performance guarantees and company policies through rigorous accuracy and auditing standards

Requirements

• High School Diploma / GED or equivalent work experience
• 1+ years of healthcare experience
• Experience with RxCLAIM™ or other claim adjudication systems
• Proficiency with Microsoft Excel (creating/editing spreadsheets and applying basic analytical formulas) and Microsoft Word
• Ability to work full-time, Monday - Friday, during normal business hours (8:00 am - 5:00 pm local time)

Preferred Qualifications

• Certified Pharmacy Technician (CPhT)
• Experience in retail pharmacy or Pharmacy Benefit Management (PBM)

Benefits

• Comprehensive benefits package including health plans and wellness support
• Financial benefits including 401k contribution and equity stock purchase options
• Incentive and recognition programs
• Opportunities for professional development and career growth

About the Company

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. We connect people with the care, pharmacy benefits, data, and resources they need to feel their best. Our culture is guided by diversity, inclusion, and a commitment to advancing health equity on a global scale.